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Showing posts sorted by date for query flu. Sort by relevance Show all posts
Showing posts sorted by date for query flu. Sort by relevance Show all posts

Friday, September 26, 2014

CDC unveils 6-phase pandemic response blueprint

The Centers for Disease Control and Prevention (CDC) today released a new influenza pandemic response plan that features six phases of activity, with the aim of providing clearer guidance on the timing of key actions, such as school closings and vaccinations.
The "Updated Preparedness and Response Framework for Influenza Pandemics" represents a revision of a framework issued in 2008, which itself was a modification of a 2006 plan. The latest iteration reflects lessons from the 2009 H1N1 pandemic and recent responses to outbreaks of novel flu viruses, such as the swine-origin variant H3N2 (H3N2v).
The six phases outlined in the revised plan are:
  • Investigation of cases of novel flu in humans or animals
  • Recognition of increased potential for ongoing transmission
  • Initiation of a pandemic wave, meaning efficient and sustained transmission
  • Acceleration of a pandemic wave, meaning a consistently increasing number of cases in the United States
  • Deceleration of a pandemic wave, defined as consistently declining cases in the United States
  • Preparation for future pandemic waves, meaning low pandemic flu activity
The framework has been aligned with the pandemic phases of the World Health Organization (WHO) as restructured last year, the document says. It says the WHO phases provide a general view by aggregating epidemic curves from around the world, and the CDC intervals "serve as additional points of reference to provide a...
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Saturday, September 20, 2014

Influenza Vaccination Coverage Among Health Care Personnel — United States, 2013–14 Influenza Season

Today post is shared from cdc.com/


Comprehensive worksite intervention strategies that include vaccination promotion and convenient access to vaccination at no cost might increase vaccination coverage among Health Care Personnel (HCP).

Influenza vaccination coverage among HCP during the 2013–14 influenza season, assessed using an opt-in Internet panel survey, was 75.2%, similar to coverage for the 2012–13 season. Vaccination coverage was highest among physicians overall and HCP working in hospital settings; coverage was lowest among assistants/aides overall and HCP working in long-term care settings. Offering vaccination at the workplace at no cost was associated with higher vaccination coverage.


The Advisory Committee on Immunization Practices recommends that all health care personnel (HCP) be vaccinated annually against influenza (1). Vaccination of HCP can reduce influenza-related morbidity and mortality among both HCP and their patients (1–4). To estimate influenza vaccination coverage among HCP during the 2013–14 season, CDC analyzed results of an opt-in Internet panel survey of 1,882 HCP conducted during April 1–16, 2014. Overall, 75.2% of participating HCP reported receiving an influenza vaccination during the 2013–14 season, similar to the 72.0% coverage among participating HCP reported in the 2012–13 season (5). Coverage was highest among HCP working in hospitals (89.6%) and lowest among HCP working in long-term care (LTC) settings (63.0%). By occupation, coverage was highest among physicians (92.2%), nurses (90.5%), nurse practitioners and physician assistants (89.6%), pharmacists (85.7%), and "other clinical personnel" (87.4%) compared with assistants and aides (57.7%) and nonclinical personnel (e.g., administrators, clerical support workers, janitors, and food service workers) (68.6%). HCP working in settings where vaccination was required had higher coverage (97.8%) compared with HCP working in settings where influenza vaccination was not required but promoted (72.4%) or settings where there was no requirement or promotion of vaccination (47.9%). Among HCP without an employer requirement for vaccination, coverage was higher for HCP working in settings where vaccination was offered on-site at no cost for 1 day (61.6%) or multiple days (80.4%) compared with HCP working in settings not offering free on-site vaccination (49.0%). Comprehensive vaccination strategies that include making vaccine available at no cost at the workplace along with active promotion of vaccination might be needed to increase vaccination coverage among HCP and minimize the risk for influenza to HCP and their patients.

Friday, September 19, 2014

Definitions of health care personnel groups for National Healthcare Safety Network reporting — United States, 2013–14 influenza season

The Advisory Committee on Immunization Practices recommends annual influenza vaccination for all health care personnel (HCP) to reduce influenza-related morbidity and mortality in health care settings.
What is added by this report?
Nationally, 81.8% of HCP included in National Healthcare Safety Network data were reported as receiving influenza vaccination during the 2013–14 influenza season. Reported proportion of HCP vaccinated was highest among employees (86.1%) and...
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* The American Hospital Association defines community hospitals as all nonfederal, short-term general, and other special hospitals (including obstetrics and gynecology; eye, ear, nose, and throat; rehabilitation; orthopedic; and other individually described specialty services) accessible by the general public.
† Data for the 2012–13 season will not be published by CDC or CMS because reporting was required beginning January 1, 2013; therefore, reported data for 2012–13 might not cover the entire influenza season.
§ Estimates of influenza vaccination coverage among health care personnel working in settings other than acute care hospitals can be obtained for selected states via the optional industry and occupation module of the Behavioral Risk Factor Surveillance System (BRFSS). This module was implemented in the 2013 BRFSS survey; module questions are available at http://www.cdc.gov/brfss/questionnaires/pdf-ques/2013%20brfss_english.pdf.
What is already known on this topic?

Influenza Vaccination Coverage Among Health Care Personnel — United States, 2013–14 Influenza Season

The figure shows the percentage of health-care personnel (HCP) who received influenza vaccination, by work setting and occupation type, in the United States for the 2010-11 through 2013-14...
The Advisory Committee on Immunization Practices recommends that all health care personnel (HCP) be vaccinated annually against influenza (1). Vaccination of HCP can reduce influenza-related morbidity and mortality among both HCP and their patients (1–4). To estimate influenza vaccination coverage among HCP during the 2013–14 season, CDC analyzed results of an opt-in Internet panel survey of 1,882 HCP conducted during April 1–16, 2014. Overall, 75.2% of participating HCP reported receiving an influenza vaccination during the 2013–14 season, similar to the 72.0% coverage among participating HCP reported in the 2012–13 season (5). Coverage was highest among HCP working in hospitals (89.6%) and lowest among HCP working in long-term care (LTC) settings (63.0%). By occupation, coverage was highest among physicians (92.2%), nurses (90.5%), nurse practitioners and physician assistants (89.6%), pharmacists (85.7%), and "other clinical personnel" (87.4%) compared with assistants and aides (57.7%) and nonclinical personnel (e.g., administrators, clerical support workers, janitors, and food service workers) (68.6%). HCP working in settings where vaccination was required had higher coverage (97.8%) compared with HCP working in settings where influenza vaccination was not required but promoted (72.4%) or settings where there was no requirement or promotion of vaccination (47.9%). Among HCP without an employer requirement for vaccination, coverage...
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Wednesday, September 3, 2014

CVS Stores Stop Selling All Tobacco Products




Today's post is shared from nytimes.com
At a CVS store near Times Square, the shelves are notable for what they no longer display: cigarettes. Now the only smoking products to be found are those that could help customers quit.
As of midnight on Tuesday, all 7,700 CVS locations nationwide will no longer sell tobacco products, fulfilling a pledge the company made in February, as it seeks to reposition itself as a health care destination.
The rebranding even comes with a new name: CVS Health.
The decision to stop selling cigarettes is a strategic move as pharmacies across the country jockey for a piece of the growing health care industry. Rebranding itself as a company focused on health could prove lucrative for the drugstore as it seeks to appeal to medical partners that can help it bridge the gap between customers and their doctors.
“CVS is really trying very hard to position themselves as the winner in that marketplace,” said Skip Snow, a health care analyst at Forrester Research. “If they can be perceived as a place to go to receive health care, and buy health care products, as opposed to the place to go to buy a bottle of whiskey or get your film developed, then they can capture more of the retail medicine dollars.”
CVS already operates 900 walk-in medical clinics, or “minute clinics,” where customers can get relatively simple services like blood pressure tests and flu vaccines. By dedicating space for these services, CVS and other major retailers like Walmart are diving into...
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Friday, July 11, 2014

CDC Laboratory Safety Errors: The Dawn of the Planet of the Apes

After watching newly released The Dawn of the Planet of the Apes, I viewed the announcement from the the Director of the US Center for Disease Control about the CDC's recent safety errors flowing from cross contamination of viruses.

One cannot miss the "CDC" logo on the vehicles all over the movie and references to the mutated laboratory virus that was accidentally released and killed most the US population.

The CDC reported today:

"The Centers for Disease Control and Prevention (CDC) released a report today that reviews the early June incident that involved the unintentional exposure of personnel to potentially viable anthrax at the CDC’s Roybal Campus. The report identifies factors found to have contributed to the incident; and highlights actions taken by the agency to address these factors and prevent future incidents. Based on a review of all aspects of the June incident, CDC concluded that while it is not impossible that staff members were exposed to viable B. anthracis, it is extremely unlikely that this occurred. None of the staff who was potentially exposed has become ill with anthrax."

Bottom line is that CDC cross contaminated deadly pathogens and potentially exposed workers subjecting both them and the population at large to deadly viruses.

Scary as it sounds, it happened. Safety protocols of all laboratory workers need dramatic improvement. That improvement should begin with our Government setting a better example for all of us to follow.

Saturday, May 3, 2014

CDC announces first case of Middle East Respiratory Syndrome Coronavirus infection (MERS) in the United States

MERS case in traveler from Saudi Arabia hospitalized in Indiana

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was confirmed today in a traveler to the United States. This virus is relatively new to humans and was first reported in Saudi Arabia in 2012.
“We’ve anticipated MERS reaching the US, and we’ve prepared for and are taking swift action,” said CDC Director Tom Frieden, M.D., M.P.H.  “We’re doing everything possible with hospital, local, and state health officials to find people who may have had contact with this person so they can be evaluated as appropriate.  This case reminds us that we are all connected by the air we breathe, the food we eat, and the water we drink.  We can break the chain of transmission in this case through focused efforts here and abroad.”

On April 24, the patient traveled by plane from Riyadh, Saudi Arabia to London, England then from London to Chicago, Illinois.  The patient then took a bus from Chicago to Indiana.  On the 27th, the patient began to experience respiratory symptoms, including shortness of breath, coughing, and fever. The patient went to an emergency department in an Indiana hospital on April 28th and was admitted on that same day. The patient is being well cared for and is isolated; the patient is currently in stable condition. Because of the patient’s symptoms and travel history, Indiana public health officials tested for MERS-CoV. The Indiana state public health laboratory and CDC confirmed MERS-CoV infection in the patient this afternoon.

“It is understandable that some may be concerned about this situation, but this first U.S. case of MERS-CoV infection represents a very low risk to the general public,” said Dr. Anne Schuchat, assistant surgeon general and director of CDC’s National Center for Immunizations and Respiratory Diseases.  In some countries, the virus has spread from person to person through close contact, such as caring for or living with an infected person. However, there is currently no evidence of sustained spread of MERS-CoV in community settings.

CDC and Indiana health officials are not yet sure how the patient became infected with the virus.  Exposure may have occurred in Saudi Arabia, where outbreaks of MERS-CoV infection are occurring. Officials also do not know exactly how many people have had close contact with the patient.
So far, including this U.S. importation, there have been 401 confirmed cases of MERS-CoV infection in 12 countries. To date, all reported cases have originated in six countries in the Arabian Peninsula.  Most of these people developed severe acute respiratory illness, with fever, cough, and shortness of breath; 93 people died. Officials do not know where the virus came from or exactly how it spreads. There is no available vaccine or specific treatment recommended for the virus.
“In this interconnected world we live in, we expected MERS-CoV to make its way to the United States,” said Dr. Tom Frieden, Director, Centers for Disease Control and Prevention.  “We have been preparing since 2012 for this possibility."

Federal, state, and local health officials are taking action to minimize the risk of spread of the virus.  The Indiana hospital is using full precautions to avoid exposure within the hospital and among healthcare professionals and other people interacting with the patient, as recommended by CDC.
In July 2013, CDC posted checklists and resource lists for healthcare facilities and providers to assist with preparing to implement infection control precautions for MERS-CoV.

As part of the prevention and control measures, officials are reaching out to close contacts to provide guidance about monitoring their health.
While experts do not yet know exactly how this virus is spread, CDC advises Americans to help protect themselves from respiratory illnesses by washing hands often, avoiding close contact with people who are sick, avoid touching their eyes, nose and/or mouth with unwashed hands, and disinfecting frequently touched surfaces.

The largest reported outbreak to date occurred April through May 2013 in eastern Saudi Arabia and involved 23 confirmed cases in four healthcare facilities. At this time, CDC does not recommend anyone change their travel plans. The World Health Organization also has not issued Travel Health Warnings for any country related to MERS-CoV.  Anyone who develops fever and cough or shortness of breath within 14 day after traveling from countries in or near the Arabian Peninsula should see their doctor and let them know where they travelled.

For more information about MERS Co-V, please visit:
Middle East Respiratory Syndrome:
http://www.cdc.gov/coronavirus/mers/index.html

About Coronavirus:
http://www.cdc.gov/coronavirus/about/index.html

Frequently Asked MERS Questions and Answers:
http://www.cdc.gov/coronavirus/mers/faq.html

Indiana Department of Health
http://www.state.in.us/isdh/External

Saturday, February 15, 2014

Yep, There's a Medical Code for Being Bitten by Shamu

Today's post was shared by Mother Jones and comes from www.motherjones.com

Sarah Kliff reports on the ongoing battle over the ICD-10, a set of medical codes for illnesses and injuries that's far more detailed than the current ICD-9:
There are different numbers for getting struck or bitten by a turkey (W61.42 or W61.43). There are codes for injuries caused by squirrels (W53.21) and getting hit by a motor vehicle while riding an animal (V80.919), spending too much time in a deep-freeze refrigerator (W93.2) and a large toe that has gone unexpectedly missing (Z89.419).
....Hospitals and insurers have fought the new codes, calling them a massive regulatory burden....ICD-10 proponents contend that adding specificity to medical diagnoses will provide a huge boon to the country. It will be easier for public health researchers, for example, to see warning signs of a possible flu pandemic — and easier for insurers to root out fraudulent claims.
“How many times are people going to be bitten by an orca? Probably not very many,” said Lynne Thomas Gordon, chief executive of the American Health Information Management Association. “But what if you’re a researcher trying to find that? You can just press a button and find that information.”
Depending on who you listen to, we are either hopelessly behind the rest of the world in implementing common-sense international standards or else the only country in the world that's holding out against the madness. Read the whole thing and decide for yourself.
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Monday, February 3, 2014

Goodbye to the Doctor’s White Coat?

Today's post was shared by The New York Times and comes from well.blogs.nytimes.com

A scene from “Grey’s Anatomy,” ABC's long-running hospital drama.
A scene from “Grey’s Anatomy,” ABC's long-running hospital drama.
Ron Tom/ABC A scene from “Grey’s Anatomy,” ABC’s long-running hospital drama.
New recommendations on what health care workers should wear may mean an end to the doctor’s white coat.
The Society for Healthcare Epidemiology of America, a professional group whose mission is to prevent and control infections in the medical workplace, has issued guidance on what health care workers should wear outside of the operating room.
The paper, in the February issue of Infection Control and Hospital Epidemiology, suggests that to minimize infection risk, hospitals might want to adopt a “bare below the elbows” policy that includes short sleeves and no wristwatch, jewelry or neckties during contact with patients.
The authors also recommend that if the use of white coats is not entirely abandoned, each doctor should have at least two, worn alternately and laundered frequently. And even if they wear the coat at other times, they should be encouraged to remove it before approaching patients.
The authors emphasize that the recommendations are based more on the biological plausibility of transmitting infection through clothing than on strong scientific evidence, which is limited.
The lead author, Dr. Gonzalo Bearman, a professor of medicine at Virginia Commonwealth University, said that hand washing, bathing patients with antibacterial soap, and checklists for inserting...
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Monday, January 27, 2014

Study: working-age adults more susceptible to severe flu

Today's post is shared from cidrap.umn.edu

Working-age adults who have diabetes are more susceptible to severe flu infections, according to a study from University of Alberta researchers who published their findings in Diabetologia. The group's goal was to compare flu levels in adults with and without the disease to help fill in knowledge gaps that underlie vaccination recommendations.

The team cohort study used data from Manitoba, Canada, from 2000 to 2008. All working-age adults were identified and paired with two nondiabetic controls.

Researchers looked at clinic visits, hospitalizations for pneumonia and flu, and all-cause hospitalization. Their analysis included 745,777 person-years of follow-up among 166,715 subjects. Those who had diabetes were more likely to be vaccinated against flu.

People with diabetes had a 6% (relative risk 1.06, 95% confidence interval 1.02 to 1.10; absolute risk difference 6 per 1,000 adults per year) greater increase in all-cause hospitalization linked to flu. However, researchers found no difference between the groups in the rates of flulike illness or pneumonia and influenza.

They concluded that the evidence is the strongest yet for targeting patients with diabetes for flu vaccination.
Jan 24 Diabetologia study

Sunday, December 29, 2013

US flu activity keeps climbing

Today's post was shared by CIDRAP and comes from www.cidrap.umn.edu

Highly magnified, digitally colorized electromicrograph of 2009 H1N1 influenza virus, the predominant strain this season.
Highly magnified, digitally colorized
 electromicrograph of 
2009 H1N1 influenza virus,
 the predominant strain this season.
US influenza activity kept climbing last week, as several states outside the South reported widespread cases, and the 2009 H1N1 virus continued to be the predominant strain, according to the US Centers for Disease Control and Prevention (CDC).
Ten states reported geographically widespread flu activity, up from just four southern states the week before. The ten are Alabama, Alaska, Kansas, Louisiana, Massachusetts, New York, Pennsylvania, Texas, Virginia, and Wyoming.
Also, six states reported high influenza-like illness (ILI) activity as measured by visits to sentinel clinics, up from four states the previous week, the CDC reported. Nationally, 3.0% of medical visits were due to ILI, compared with the national baseline of 2.0%.
States with high ILI activity were Alabama, Louisiana, Mississippi, Missouri, Oklahoma, and Texas. Another eight states cited moderate ILI activity, and the rest had low or minimal numbers.
The CDC also reported a big jump in the percentage of respiratory samples that tested positive for flu: 24.1% (of 6,813 specimens), versus 17.8% a week earlier.

An H1N1 season so far

Of the positive specimens, more than 98% were influenza A viruses, and 2009 H1N1—the former pandemic virus, now a seasonal strain—accounted for nearly all of those that were subtyped. Only 1.8% of the positive specimens were influenza B isolates.
Last week the...
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Thursday, December 26, 2013

Bloomberg Public Health Legacy Lauded In NYC

Today's post was shared by RWJF PublicHealth and comes from www.huffingtonpost.com


Michael Bloomberg steered New York City through economic recession, a catastrophic hurricane and the aftermath of 9/11, but he may always be remembered, accurately or not, as the mayor who wanted to ban the Big Gulp.
After 12 years, Bloomberg leaves office Dec. 31 with a unique record as a public health crusader who attacked cigarettes, artery-clogging fats and big sugary drinks with as much zeal as most mayors go after crack dens and graffiti.
And while Bloomberg's audacious initiatives weren't uniformly successful, often leading to court challenges and criticisms he was turning New York into a "nanny state," experts say they helped reshape just how far a city government can go to protect people from an unhealthy lifestyle.
"He has been a transformative leader," said Dr. Linda Fried, dean of Columbia University's school of public health. "He has created a model for how to improve a city's health."
Coming into office as a billionaire businessman who made his fortune selling data to Wall Street, Bloomberg was accustomed to using hard, cold research to drive decisions, and it was an approach he used effectively on matters of public health.
Bloomberg pushed to ban smoking in indoor public spaces and prohibit cigarette sales to anyone under 21. He got artificial trans-fat banned from restaurant food — an action that led fast food giants like McDonald's and Dunkin Donuts to change their recipes rather than lose access to the...
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Saturday, December 21, 2013

The Flu Is One Gift That We Don't Have To Keep On Giving For People With Cancer

Today's post was shared by CDC Cancer and comes from www.cancer.org


It's the holiday season, a time of reflection, celebration and for many, giving gifts. But there is at least one gift that no one wants to get, and certainly no one wants to give: the flu. And for people with cancer, and those they come in contact with, the flu can be a very serious event. For that reason and many more, people more than 6 months old-and especially those in contact with people who have serious illnesses like cancer-should get vaccinated against the flu.
Too many of us think the flu is a minor inconvenience. But that is almost certainly because we confuse the typical cold or upper respiratory infection, which usually means discomfort and maybe a day or two off work.  Influenza is a much different and much more dangerous animal, especially to people with chronic diseases.
Over time we have become somewhat immune to the messages about the dangers of the flu, now that we have vaccinations and medicines which can treat the illness. Few are alive who remember anything about the great influenza pandemic of 1918:
"The influenza of that season, however was far more than a cold...The flu was most deadly for people ages 20-40...It infected 28% of all Americans (Tice). An estimated 675,000 Americans died of influence during the pandemic, ten times as many as in the world war. Of the US soldiers who died in Europe, half of them fell to the influenza virus and not the enemy (Deseret News) An estimated 43,000 servicemen mobilized for WWI died of influenza...
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Sunday, December 15, 2013

Your Flu Shot is Waiting

Today's post was shared by RWJF PublicHealth and comes from www.rwjf.org

New reports from the U.S. Centers for Disease Control and Prevention (CDC) show that 39 percent of adults and 41 percent of children six months and older got their flu shots for the 2013-2014 season by early November—a rate similar to flu vaccination coverage last season at the same time.
Other flu shot statistics of note this year include:
  • Vaccination among pregnant women (41 percent) and health care providers (63 percent) is about the same as it was this time last year
  • High rates were seen again this year among health care providers including pharmacists (90 percent), physicians (84 percent) and nurses (79 percent), but the CDC reported much lower vaccination rates among assistants or aides (49 percent) and health care providers working in long-term care facilities (53 percent)
“We are happy that annual flu vaccination is becoming a habit for many people, but there is still much room for improvement,” says Anne Schuchat, MD, director of the National Center for Immunization and Respiratory Diseases at CDC. “The bottom line is that influenza can cause a tremendous amount of illness and can be severe. Even when our flu vaccines are not as effective as we want them to be, they can reduce flu illnesses, doctors' visits, and flu-related hospitalizations and deaths.”
Seasonal influenza activity is increasing in parts of the United States. Further increases in influenza activity across the country are expected in the coming weeks. “If you have not...
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Friday, December 13, 2013

Carbon Monoxide Safety Facts and Tips – How to prevent poisoning from a gas with no odor

Today's post was shared by US Dept. of Labor and comes from www.nsc.org

     NSC HOME > News & Resources > Resources > Carbon Monoxide   
 
Carbon Monoxide
Carbon Monoxide Safety Facts and Tips 
Carbon monoxide (CO) is an odorless, colorless gas that interferes with the delivery of oxygen in the blood to the rest of the body. It is produced by the incomplete combustion of fuels.
What Are the Major Sources of CO?
Carbon monoxide is produced as a result of incomplete burning of carbon-containing fuels including coal, wood, charcoal, natural gas, and fuel oil. It can be emitted by combustion sources such as unvented kerosene and gas space heaters, furnaces, woodstoves, gas stoves, fireplaces and water heaters, automobile exhaust from attached garages, and tobacco smoke. Problems can arise as a result of improper installation, maintenance, or inadequate ventilation.
What Are the Health Effects?
Carbon monoxide interferes with the distribution of oxygen in the blood to the rest of the body. Depending on the amount inhaled, this gas can impede coordination, worsen cardiovascular conditions, and produce fatigue, headache, weakness, confusion, disorientation, nausea, and dizziness. Very high levels can cause death.
The symptoms are sometimes confused with the flu or food poisoning. Fetuses, infants, elderly, and people with heart and respiratory illnesses are particularly at high risk for the adverse health effects of carbon monoxide.
An average of 166 people die each year as a...

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Thursday, December 5, 2013

President Obama Statement on the Benefits of the Affordable Care Act

Thanks to Monica, thanks to everybody standing behind me, and thanks for everybody out there who cares deeply about this issue.  Monica’s story is important because for all the day-to-day fights here in Washington around the Affordable Care Act, it’s stories like hers that should remind us why we took on this reform in the first place.
And for too long, few things left working families more vulnerable to the anxieties and insecurities of today’s economy than a broken health care system.  So we took up the fight because we believe that, in America, nobody should have to worry about going broke just because somebody in their family or they get sick.  We believe that nobody should have to choose between putting food on their kids’ table or taking them to see a doctor.  We believe we’re a better country than a country where we allow, every day, 14,000 Americans to lose their health coverage; or where every year, tens of thousands of Americans died because they didn’t have health care; or where out-of-pocket costs drove millions of citizens into poverty in the wealthiest nation on Earth.  We thought we were better than that, and that’s why we took this on.  (Applause.)
And that’s what’s gotten lost a little bit over the last couple of months.  And our focus, rightly, had to shift towards working 24/7 to fix the website, healthcare.gov, for the new marketplaces where people can buy affordable insurance plans.  And today, the website is working well for the vast majority of users.  More problems may pop up, as they always do when you’re launching something new.  And when they do, we’ll fix those, too.  But what we also know is that after just the first month, despite all the problems in the rollout, about half a million people across the country are poised to gain health care coverage through marketplaces and Medicaid beginning on January 1st -- some for the very first time.  We know that -- half a million people.  (Applause.)  And that number is increasing every day and it is going to keep growing and growing and growing, because we know that there are 41 million people out there without health insurance.  And we know there are a whole bunch of folks out there who are underinsured or don’t have a good deal.  And we know the demand is there and we know that the product on these marketplaces is good and it provides choice and competition for people that allow them, in some cases for the very first time, to have the security that health insurance can provide. 
The bottom line is this law is working and will work into the future.  People want the financial stability of health insurance.  And we’re going to keep on working to fix whatever problems come up in any startup, any launch of a project this big that has an impact on one-sixth of our economy, whatever comes up we’re going to just fix it because we know that the ultimate goal, the ultimate aim, is to make sure that people have basic security and the foundation for the good health that they need.
Now, we may never satisfy the law’s opponents.  I think that’s fair to say.  Some of them are rooting for this law to fail -- that’s not my opinion, by the way, they say it pretty explicitly.  (Laughter.)  Some have already convinced themselves that the law has failed, regardless of the evidence.  But I would advise them to check with the people who are here today and the people that they represent all across the country whose lives have been changed for the better by the Affordable Care Act.
The other day I got a letter from Julia Walsh in California.  Earlier this year, Julia was diagnosed with leukemia and lymphoma.  “I have a lot of things to worry about,” she wrote.  “But thanks to the [Affordable Care Act], there are lots of things I do not have to worry about, like…whether there will be a lifetime cap on benefits, [or] whether my treatment will bankrupt my family…I can’t begin to tell you how much that peace of mind means...”  That’s what the Affordable Care Act means to Julia.  She already had insurance, by the way, but because this law banned lifetime limits on the care you or your family can receive, she’s never going to have to choose between providing for her kids or getting herself well -- she can do both. 
Sam Weir, a doctor in North Carolina, emailed me the other day.  “The coming years will be challenging for all of us in family medicine,” he wrote.  “But my colleagues and I draw strength from knowing that beginning with the new year the preventive care many of our current patients have been putting off will be covered and the patients we have not yet seen will finally be able to get the care that they have long needed.”  That’s the difference that the Affordable Care Act will make for many of Dr. Weir’s patients.  Because more than 100 million Americans with insurance have gained access to recommended preventive care like mammograms, or colonoscopies, or flu shots, or contraception to help them stay healthy -- at no out-of-pocket cost.  (Applause.)
At the young age of 23, Justine Ula is battling cancer for the second time.  And the other day, her mom, Joann, emailed me from Cleveland University Hospital where Justine is undergoing treatment.  She told me she stopped by the pharmacy to pick up Justine’s medicine.  If Justine were uninsured, it would have cost her $4,500.  But she is insured -- because the Affordable Care Act has let her and three million other young people like Monica gain coverage by staying on their parents’ plan until they’re 26.  (Applause.)  And that means Justine’s mom, all she had to cover was the $25 co-pay. 
Because of the Affordable Care Act, more than 7 million seniors and Americans with disabilities have saved an average of $1,200 on their prescription medicine.  (Applause.)  This year alone, 8.5 million families have actually gotten an average of $100 back from their insurance company -- you don’t hear that very often -- (laughter) -- because it spent too much on things like overhead, and not enough on their care.  And, by the way, health care costs are rising at the slowest rate in 50 years.  So we’re actually bending the cost of health care overall, which benefits everybody.  (Applause.)
So that’s what this law means to millions of Americans.  And my main message today is:  We’re not going back.  We’re not going to betray Monica, or Julia, or Sam, or Justine, or Joann.  (Applause.)  I mean, that seems to be the only alternative that Obamacare’s critics have is, well, let’s just go back to the status quo -- because they sure haven’t presented an alternative.  If you ask many of the opponents of this law what exactly they’d do differently, their answer seems to be, well, let’s go back to the way things used to be.
Just the other day, the Republican Leader in the Senate was asked what benefits people without health care might see from this law.  And he refused to answer, even though there are dozens in this room and tens of thousands in his own state who are already on track to benefit from it.  He just repeated “repeal” over and over and over again.  And obviously we’ve heard that from a lot of folks on that side of the aisle.
Look, I’ve always said I will work with anybody to implement and improve this law effectively.  If you’ve got good ideas, bring them to me.  Let’s go.  But we’re not repealing it as long as I’m President and I want everybody to be clear about that.  (Applause.) 
We will make it work for all Americans.  If you don’t like this law -- (applause) -- so, if despite all the millions of people who are benefitting from it, you still think this law is a bad idea then you’ve got to tell us specifically what you’d do differently to cut costs, cover more people, make insurance more secure.  You can’t just say that the system was working with 41 million people without health insurance.  You can’t just say that the system is working when you’ve got a whole bunch of folks who thought they had decent insurance and then when they got sick, it turned out it wasn’t there for them or they were left with tens of thousands of dollars in out-of-pocket costs that were impossible for them to pay.
Right now, what that law is doing -- (baby talks.)  Yes, you agree with me.  (Laughter.)  Right now, what this law is doing is helping folks and we’re just getting started with the exchanges, just getting started with the marketplaces.  So we’re not going to walk away from it.  If I’ve got to fight another three years to make sure this law works, then that’s what I’ll do.  That’s what we’ll do.  (Applause.)
But what’s important for everybody to remember is not only that the law has already helped millions of people but that there are millions more who stand to be helped.  And we’ve got to make sure they know that.  And I’ve said very clearly that our poor execution in the first couple months on the website clouded the fact that there are a whole bunch of people who stand to benefit.  Now that the website is working for the vast majority of people, we need to make sure that folks refocus on what’s at stake here, which is the capacity for you or your families to be able to have the security of decent health insurance at a reasonable cost through choice and competition on this marketplace and tax credits that you may be eligible for that can save you hundreds of dollars in premium costs every month, potentially.
So we just need people to -- now that we are getting the technology fixed -- we need you to go back, take a look at what’s actually going on, because it can make a difference in your lives and the lives of your families.  And maybe it won’t make a difference right now if you’re feeling healthy, but I promise you, if somebody in your family -- heaven forbid -- gets sick, you’ll see the difference.  And it will make all the difference for you and your families.
So I’m going to need some help in spreading the word -- I’m going to need some help in spreading the word.  I need you to spread the word about the law, about its benefits, about its protections, about how folks can sign up.  Tell your friends.  Tell your family.  Do not let the initial problems with the website discourage you because it’s working better now and it’s just going to keep on working better over time.  Every day I check to make sure that it’s working better.  (Laughter.)  And we’ve learned not to make wild promises about how perfectly smooth it’s going to be at all time, but if you really want health insurance through the marketplaces, you’re going to be able to get on and find the information that you need for your families at healthcare.gov.
So if you’ve already got health insurance or you’ve already taken advantage of the Affordable Care Act, you’ve got to tell your friends, you’ve got to tell your family.  Tell your coworkers.  Tell your neighbors.  Let’s help our fellow Americans get covered.  Let’s give every American a fighting chance in today’s economy.
Thank you so much, everybody.  God bless you.  God bless America.  (Applause.)