Florida overcomes GOP barriers to enroll uninsured

MIAMI (AP) — Florida's Republican leaders have fought the Affordable Care Act at every turn, banning navigators from county health departments, offering no state dollars to boost outreach efforts to 3.5 million uninsured and leading the fight to repeal the law. Yet the state has emerged as a tale of what went right with President Barack Obama's health care overhaul.

More than 440,000 Florida residents had been enrolled through the federal marketplace through the end of February.

Florida's success is due partly to infrastructure created in the swing state by Democratic-affiliated groups during the last three presidential elections, along with continued investment by the Obama administration and nonprofit advocacy groups in the diverse state that will be competitive in November's midterm election.

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Treasury says Lew leaves hospital after surgery

WASHINGTON (Reuters) - U.S. Treasury Secretary Jack Lew was discharged from a hospital on Wednesday following a surgery to treat a benign enlarged prostate, a Treasury spokesperson said.

"(Lew) is now at home recuperating from his surgical procedure yesterday," Treasury spokeswoman Natalie Wyeth Earnest said in a statement. "He is in good spirits, talking with staff, and looks forward to being back in the office next week."

The spokeswoman had said on Tuesday the surgery went well but that Lew's doctor decided to keep him in the hospital overnight because he was running a low fever.

Lew, 58, was sworn in as Treasury secretary in February 2013 after serving as President Barack Obama's chief of staff.

(Reporting by Timothy Ahmann; Editing by Chizu Nomiyama)

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Doctors Really Do Raise Your Blood Pressure

WEDNESDAY, March 26, 2014 (HealthDay News) -- Patients' blood pressure readings are notably higher when they're taken by a doctor than by a nurse, a new study finds.

This link between doctors and higher blood pressure readings is known as the "white coat effect," and is believed to be the result of patients being more nervous when examined by a physician.

This effect has been noted in a number of previous studies, but this new paper is the first to confirm it, according to the study authors.

The investigators analyzed data from more than 1,000 people who had blood pressure readings taken by both doctors and nurses during the same visit. The readings taken by doctors were significantly higher than those taken by nurses, the study authors found.

The findings, published in the current issue of the British Journal of General Practice, should lead to changes in the way blood pressure readings are taken, according to lead author Dr. Christopher Clark, of the University of Exeter Medical School, in England.

"Doctors should continue to measure blood pressure as part of the assessment of an ill patient or a routine check-up, but not where clinical decisions on blood pressure treatment depend on the outcome," Clark said in a university news release.

"The difference we noted is enough to tip some patients over the threshold for treatment for high blood pressure, and unnecessary medication can lead to unwanted side-effects," he said.

"Some patients may be erroneously asked to continue to monitor their own blood pressure at home, which can build anxiety. These inappropriate measures could all be avoided by the simple measure of someone other than a doctor taking the blood pressure recording," Clark added.

He suggested that researchers "should also think carefully about how to account for this effect in studies that compare treatment by doctors and nurses. Some studies have concluded that nurses are better at treating [high blood pressure], when in fact those findings could be down to this recording bias."

More information

The U.S. National Heart, Lung, and Blood Institute explains how to prevent high blood pressure.

Copyright c 2014?HealthDay. All rights reserved.

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Virginia lawmakers recess without Medicaid, budget deal

By Gary Robertson

RICHMOND, Virginia (Reuters) - Virginia's legislature has recessed without reaching agreement with Democratic Governor Terry McAuliffe over a budget or Medicaid expansion.

McAuliffe, a former Democratic Party fundraiser, and the Republican-dominated House of Delegates are deadlocked over a two-year pilot expansion of Medicaid, the federal healthcare program for the poor the governor has proposed.

House lawmakers meeting in a two-day special session defeated McAuliffe's proposed $96 billion two-year budget late on Tuesday. The House then passed its own version of the budget without Medicaid expansion, seen as a priority for the governor, before adjourning.

The Democratic-controlled state Senate will reconvene April 7 to take up the budget fight anew. A budget must be approved by June 30 or risk state operations starting to shut down.

Republicans are asking McAuliffe to deal with the budget and Medicaid in separate sessions.

"We would be more than happy to debate Medicaid in a special session," said Kirk Cox, Republican House majority leader. "I think is afraid he loses all his leverage without the budget."

McAuliffe, who made Medicaid expansion the centerpiece of his gubernatorial campaign last year, has not responded to the rebuff.

But he has said that accepting $2 billion in federal funds to expand Medicaid under the Affordable Care Act would release money that could be used to create jobs, raise state salaries, bolster pensions and implement health reforms.

(Editing by Ian Simpson and Gunna Dickson)

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One in 25 patients battling hospital-acquired infections: CDC

By Gene Emery

NEW YORK (Reuters Health) - On any given day, one in 25 hospitalized patients - 4 percent - is battling an infection picked up in a hospital or other healthcare facility, according to a new survey by the Centers for Disease Control and Prevention (CDC).

That translates to more than 600,000 hospital patients each year. Roughly 74,000 of them have to fight more than one hospital-acquired infection, researchers found.

About half of those infections were either linked to a device attached to the patient, like a catheter or ventilator, or occurred after a surgical procedure at the site of the surgery.

Previous estimates had pegged the annual number of infections at 2.1 million in the 1970s and 1.7 million from 1990 through 2002.

"The trend, in magnitude, seems to be going in the right direction," Dr. Mike Bell, deputy director of the Division of Healthcare Quality Promotion at the CDC, told Reuters Health.

Despite continuing concern about hospital-acquired infections, especially ones that are resistant to antibiotics, the U.S. does not have a national system for collecting information on the problem.

The new study, led by Dr. Shelley S. Magill of the CDC and published in the New England Journal of Medicine, was based on an analysis of 11,282 patients treated at 183 hospitals in 10 states. The survey in each hospital was done over the course of a day, involving as many as 100 patients per facility.

Pneumonia accounted for about 22 percent of the hospital-acquired infections. Another 22 percent were infections at the surgical site, and 17 percent were stomach or intestinal illnesses. Urinary tract and bloodstream infections ranked fourth and fifth, respectively.

The most common bacterium responsible was Clostridium difficile, which kills an estimated 14,000 people in the U.S. each year. It was detected in 12 percent of the hospital-acquired illnesses and was responsible for 71 percent of gastrointestinal infections in particular.

Nursing homes, emergency departments, rehabilitation hospitals and outpatient treatment centers were not included in the tally.

The researchers estimated that in 2011, 648,000 hospitalized patients had to battle at least one hospital-acquired infection. The total number of infections was estimated at 721,800. To put that number in perspective, about 34 million people are admitted to 5,000 community hospitals in the U.S. each year.

The new report "validates the work we've been doing, focusing on some of the severe infections related to intensive care, related to devices such as catheters in the bloodstream or the bladder, mechanical ventilation or surgical procedures," Bell said.

To prevent infections, the National Patient Safety Foundation recommends patients wash their hands regularly and remind their doctors and nurses to do the same. Patients should also make sure both bandages and the skin around any catheters are kept clean and dry, it says.

SOURCE: http://bit.ly/1rzGOHe New England Journal of Medicine, online March 26, 2014.

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