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Cutting Medicaid?

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Cutting Medicaid?

Republican leaders in Congress have directed the committee that oversees Medicaid to cut $880 billion from the next budget. They say these cuts aren’t necessarily aimed at Medicaid, the insurance program for 72 million poor and disabled Americans. The cuts could come from Medicare, for instance. But Trump has vowed not to touch that very popular program. And a sum this large can’t come from anywhere else.

The Republican process is just getting started, and we don’t yet know how lawmakers will change the program. Most Medicaid money goes to states, so the best way to think about the proposal is as a cut to state budgets. State lawmakers could react by dropping coverage, raising taxes or slashing other parts of their budget. In today’s newsletter, I’ll explain a few possible scenarios.

Medicaid was designed to divide a patient’s medical bills: the federal government and the state would each pay a set share. (A state’s contribution depends on how poor it is.)

The law is precise about what Medicaid must cover — cancer screenings and kidney transplants, for instance, but not prosthetic legs — and Republicans can’t change that with a budget bill. Every state has to cover certain populations, including poor children, pregnant women, people with disabilities and patients in nursing homes who run out of money.

Most states also choose to cover an optional group that was added as part of Obamacare in 2014: anyone who earns less than a certain income (around $21,000 for a single person). Republicans want to impose a work requirement on this group for people who aren’t disabled. That idea is popular with the public but would save the federal government only around $100 billion, not enough to meet the G.O.P. target.

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Anything more to lower the federal government’s share would put the burden on states. And lawmakers there could deal with the problem in their own ways. They could cut optional populations like the Obamacare group. Twelve states have laws that will automatically do this if federal funding drops. If they don’t want to drop people, states can drop optional benefits, such as prescription drug coverage.

After those cuts, states face tough choices.

They could pay doctors, hospitals and nursing homes less for care. But there is a limit. If Mississippi suddenly started paying $50 for an echocardiogram instead of around $160, cardiologists might stop seeing Medicaid patients. (Many Medicaid patients already struggle to find care because the program pays doctors so little.) Cuts like these could also put some nursing homes or rural hospitals out of business.

Even so, states would still need a lot more money for Medicaid, usually their second-largest expense after education.

Where could they get it? They’d have to sacrifice other priorities. One option is to cut education. Another is to raise taxes. None of these would be required by federal legislation; it’s up to the states how they cope. That allows Republicans in Congress to say they are not cutting Medicaid benefits or eligibility, even if that is the inevitable effect in most places.

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Republicans point out that the original pact between Washington and the states has frayed, and feds are covering more than their share. That’s true. Through various accounting gimmicks, states have lowered their Medicaid contributions and now pay about a third of the bill, on average. Plus, Washington assumed almost the whole cost of the 2014 Obamacare expansion.

But that expansion has made Medicaid popular. More than half of Americans say someone in their family has used the program, and only 17 percent support cutting its budget. Local lawmakers also probably won’t win over voters by chopping education or raising taxes to save Medicaid. That’s why Democrats have settled on Medicaid as their top talking point about the G.O.P. budget plan.

Republicans tried to cut Medicaid’s budget in 2017, too. Grassroots opposition helped defeat the effort, as did extensive lobbying by Republican governors, who urged senators not to leave them with a huge fiscal hole.

The unpopularity of that bill — and its failure — helped Democrats retake the House the next year.

Related: Cutting Medicaid, taxing scholarships and killing invasive plants: A guide to the Republican wish list.

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In India, young people are driving a boom in book festivals big and small. These readers are increasingly consuming books in their native tongues and in English. They are learning in ways that India’s higher education system — with its focus on exams — often does not encourage.

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Space experiments reveal new way to fight drug-resistant superbugs, scientists say

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Space experiments reveal new way to fight drug-resistant superbugs, scientists say

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Research conducted partly aboard the International Space Station (ISS) suggests that “microgravity” could help scientists fight drug-resistant superbugs, according to a report from SWNS.

Microgravity is the condition in which people or objects appear to be weightless, NASA states.

Experiments by researchers at the University of Wisconsin-Madison show that viruses and bacteria behave differently in near-weightless conditions. In space, they develop genetic changes not typically seen on Earth.

DEADLY ‘SUPERBUG’ IS SPREADING ACROSS US AS DRUG RESISTANCE GROWS, RESEARCHERS WARN

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Lead study author Dr. Phil Huss, a researcher at the University of Wisconsin–Madison, noted that interactions between viruses that infect bacteria — known as phages — and their hosts play an “integral” role in how microbial ecosystems function, per the SWSN report.

Viruses that infect bacteria were still able to infect E. coli in space. However, the way those infections unfolded was different from what is typically observed on Earth.

E. coli is a group of bacteria that can live in the gut and are harmless most of the time, according to Cleveland Clinic. (iStock)

Bacteria and phages are often described as being locked in an evolutionary arms race, Huss said, with each side constantly adapting to outmaneuver the other.

“Microgravity is not just a slower or noisier version of Earth — it is a distinct physical and evolutionary environment,” researcher Srivatsan Raman, Ph.D., professor of biochemistry at the university, told Fox News Digital. 

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“Even in a very simple phage-bacteria system, microgravity altered infection dynamics and pushed both organisms down different evolutionary paths,” he added.

CONTAMINATED MEAT BLAMED FOR RISE IN COMMON URINARY INFECTIONS, EXPERTS WARN

While these interactions between bacteria and phages have been well-studied on Earth, few studies have examined them in space, where they can lead to different outcomes.

For the study, Huss and his colleagues compared two sets of E. coli samples infected with a phage known as T7. One set was incubated on Earth, while the other was grown aboard the ISS.

The ISS is a microgravity environment — where people and objects appear weightless. (NASA / SWNS)

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The team found that after an initial slowdown, the T7 phage successfully infected E. coli in space. Genetic analysis later revealed clear differences in how both the bacteria and the virus mutated in space compared with how they behaved on Earth, per the report.

Huss said the phages grown aboard the space station developed mutations that could improve their ability to infect bacteria or attach to bacterial cells. At the same time, the E. coli grown in space developed mutations that could help them resist infection and survive better in near-weightless conditions.

GROWING ANTIBIOTIC CRISIS COULD TURN BACTERIAL INFECTIONS DEADLY, EXPERTS WARN

Raman said some of the findings were unexpected. In particular, he noted, microgravity led to mutations in parts of the phage genome that are not well-understood and are rarely seen in Earth-based experiments.

The E. coli grown in space developed mutations that could help them resist infection and survive better in near-weightless conditions. (iStock)

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Researchers then used a technique called deep mutational scanning — a method that tracks how genetic changes affect function — to examine changes in the T7 receptor-binding protein, which plays a key role in infection.

Additional experiments on Earth linked those changes to increased effectiveness against E. coli strains that are normally resistant to T7.

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“Equally surprising was that phages shaped by microgravity could be more effective against terrestrial bacterial pathogens when brought back to Earth,” Raman told Fox News Digital.

“That result suggests microgravity can reveal combinations of mutations that are difficult to access through standard laboratory evolution, but [are] still highly relevant for real-world applications.”

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“Microgravity is not just a slower or noisier version of Earth — it is a distinct physical and evolutionary environment.”

Huss said the findings could help address antibiotic-resistant infections, including urinary tract infections, which have been increasing in recent years.

“By studying those space-driven adaptations, we identified new biological insights that allowed us to engineer phages with far superior activity against drug-resistant pathogens back on Earth,” Huss told SWNS.

Study limitations

“Experiments on the ISS are constrained by small sample sizes, fixed hardware and scheduling constraints,” Raman noted. “Samples also experience freezing and long storage times, which can complicate interpretation.”

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He added that the research has broader implications.

“Studying microbes in space isn’t just about space biology,” Raman said. “These experiments can uncover new aspects of viral infection and microbial evolution that feed directly back into terrestrial problems, including antimicrobial resistance and phage therapy.”

Space should be treated as a discovery environment rather than a routine testing platform, one researcher said. (iStock)

He added that space should be treated as a discovery environment rather than a routine testing platform. The most effective approach, according to Raman, is to identify useful patterns and mutations in space and then study them carefully in Earth-based systems.

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Scientists also noted that the findings highlight how microbial ecosystems, like those associated with humans, could change during long space missions.

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“Understanding and anticipating those changes will be essential as space travel becomes longer, more routine and more biologically complex,” Raman said.

The findings were published in the journal PLOS Biology.

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Blood test flags digestive disease risk years before symptoms appear

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Blood test flags digestive disease risk years before symptoms appear

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A simple blood test may detect Crohn’s disease years before symptoms appear, according to a new study reported by SWNS.

Canadian researchers say the discovery could enable earlier diagnosis and potential prevention of the chronic inflammatory bowel disease (IBD).

The test measures the immune system’s response to flagellin, a protein found in gut bacteria. Researchers found that this response is elevated in some people years before Crohn’s develops.

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The findings, published in Clinical Gastroenterology and Hepatology, highlight the “interplay” between gut bacteria and immune system responses as a key step in the disease’s development, per the SWNS report.

Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract that causes persistent digestive symptoms, pain and fatigue, significantly affecting quality of life. Its incidence among children has doubled since 1995, according to official figures.

Crohn’s disease is a type of inflammatory bowel disease (IBD) that causes swelling and irritation of the tissues, called inflammation, in the digestive tract.  (iStock)

The presence of flagellin antibodies long before symptoms appear suggests that the immune reaction may help trigger the disease, according to research leader Dr. Ken Croitoru, clinician-scientist and professor of medicine and immunology at the University of Toronto. 

A better understanding of this early process could lead to improved prediction, prevention and treatment, the expert said.

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“We haven’t cured anybody yet, and we need to do better.”

“With all the advanced biologic therapy we have today, patients’ responses are partial at best,” Croitoru told SWNS. “We haven’t cured anybody yet, and we need to do better.”

MISUNDERSTOOD ILLNESS LEAVES MILLIONS EXHAUSTED, WITH MOST CASES UNDIAGNOSED

“We wanted to know: Do people who are at risk, who are healthy now, have these antibodies against flagellin?” he said. “We looked, we measured, and yes indeed, at least some of them did.”

This new research is part of the Genetic, Environmental and Microbial (GEM) Project, which has followed more than 5,000 healthy first-degree relatives of people with Crohn’s disease worldwide since 2008. The project collects genetic, biological and environmental data to better understand how the disease develops.

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The presence of flagellin antibodies long before symptoms appear suggests that the immune reaction may help trigger the disease, according to the lead researcher. (iStock)

The study followed 381 first-degree relatives of Crohn’s patients, 77 of whom later developed the disease. Of those, more than 30% had elevated antibody responses.

The responses were strongest in siblings, underscoring the role of shared environmental exposure, researchers said.

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So far, 130 of the study participants have developed Crohn’s, giving researchers a rare opportunity to study its earliest stages. The average time from blood sample collection to diagnosis was nearly 2-½ years.

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Previous GEM research showed that an inflammatory immune response targeting gut bacteria can appear long before the disease develops. 

The study followed 381 first-degree relatives of Crohn’s patients, 77 of whom later developed the disease. (iStock)

In healthy people, gut bacteria coexist peacefully and play an essential role in digestive health — but in Crohn’s patients, the immune system appears to mount an abnormal response against the microbes, experts say.

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The Canadian team also confirmed that this pre-disease immune response was associated with intestinal inflammation and gut barrier dysfunction, both hallmarks of Crohn’s disease. 

The study did have some limitations, including that it did not include experiments to show exactly how the immune response might lead to Crohn’s disease.  (iStock)

Research team member Dr. Sun-Ho Lee, a gastroenterologist, commented that this new study supports the idea of designing a flagellin-directed vaccine for certain high-risk individuals to prevent the disease, according to SWNS.

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The study did have some limitations, including that it did not include experiments to show exactly how the immune response might lead to Crohn’s disease. 

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As a result, the researchers could not determine the biological steps linking the immune reaction to the onset of the illness. “Further validation and mechanistic studies are underway,” they noted.

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Simple daily habit may help ease depression more than medication, researchers say

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Simple daily habit may help ease depression more than medication, researchers say

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This story discusses suicide. If you or someone you know is having thoughts of suicide, please contact the Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255).

A new study suggests that exercise can treat depression just as effectively as therapy and antidepressants.

A Cochrane review looked at 73 randomized controlled trials involving nearly 5,000 adults with a depression diagnosis. The studies compared exercise with either other active treatments — such as therapy or medication — or with “inactive interventions,” like being placed on a wait list or in a control group.

The London-based team discovered that exercise may be “moderately effective” compared to no therapy in reducing depression symptoms, according to a press release.

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EXERCISE AFFECTS THE HEART IN A HIDDEN, POWERFUL WAY BY REWIRING NERVES, STUDY FINDS

“There is probably little to no difference in depressive symptoms between people undertaking exercise and those receiving psychological therapy,” the authors noted in a study discussion on Cochrane’s website, and “there may be little to no difference in depressive symptoms between people doing exercise and those taking antidepressants.”

The analysis discovered that exercise may be “moderately effective” compared to no therapy in reducing depression symptoms. (iStock)

The review found that light- to moderate-intensity exercise was more beneficial for easing depression symptoms than vigorous exercise.

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No single type of physical activity stood out as the best, but mixed programs that included resistance training appeared to be “more effective” than just aerobic exercise. 

Some forms of exercise, like yoga and stretching, were not included in the analysis, but are areas to be further researched, the review noted.

Mixed exercise programs and resistance training appeared to be “more effective” in easing depression symptoms than just aerobic exercise. (iStock)

Professor Andrew Clegg, lead author of the review, wrote in a statement that exercise “appears to be a safe and accessible option for helping to manage symptoms of depression.”

“This suggests that exercise works well for some people, but not for everyone, and finding approaches that individuals are willing and able to maintain is important,” he said.

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Study limitations and risks

The researchers noted that there was a high risk of bias in some of the studies included in the review, and noted that the long-term effects of exercise on depression symptoms remain uncertain.

COMMON SPICE MAY BEAT DEPRESSION AND BOOST SEXUAL HEALTH, DOCTOR SAYS

Clegg noted that “larger, high-quality studies” are needed to determine which types of exercise work best and whether the benefits last over time.

The comparison between exercise and other treatments and how they benefit people’s quality of life were also “inconsistent and uncertain.”

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“Adverse events from exercise were not common,” the researchers mentioned. “The small number of participants who experienced them usually reported muscle and joint problems or worsening of depression.”

About 21 million U.S. adults had at least one major depressive episode in a recent year — equivalent to roughly 8.3% of all U.S. adults, according to the National Institutes of Health. (iStock)

“Future research should focus on improving the quality of the studies, working out which characteristics of exercise are effective for different people, and ensuring different types of people are included in the studies so that health equity issues can be considered,” they went on.

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About 21 million U.S. adults had at least one major depressive episode in a recent year — equivalent to roughly 8.3% of all U.S. adults, according to the National Institute of Mental Health.

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Depression symptoms include feelings of sadness, hopelessness, anxiety, guilt or irritability, as well as loss of interest or pleasure in hobbies and activities. Fatigue, poor concentration, sleep disturbances, appetite changes and social withdrawal are also red flags, in addition to thoughts about dying or suicidal ideations. 

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The condition is most often treated by antidepressant medications and psychological therapies, such as talk therapy. Anyone who needs help should consult their doctor.

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