Sunday, August 23, 2009

News Clipping Archives

 

 

Maryland / Regional

Centers help ease the road to retirement (Baltimore Sun)

 

National / International

Swine Flu Campaign Waits on Vaccine (Washington Post)

Officials Weigh Circumcision to Fight H.I.V. Risk (New York Times)

 

Opinion

Seniors hit hard on health care (Carroll County Times Letter to the Editor)

 

 

Maryland / Regional

Centers help ease the road to retirement

Seniors get financial incentives to move into communities

 

By Andrea K. Walker

Baltimore Sun

Sunday, August 23, 2009

 

 

It's the time in life people spend years working and saving to reach.

 

The time when they get to the age where they can stop working, tap into their 401(k) accounts, sell their homes and move into a retirement community. Finally, someone else can mow the lawn and fix the toilet when it breaks.

 

Or maybe, they can't move around as much by themselves anymore and choose to live in an assisted-living center where they can get help with basic needs.

 

But seniors are feeling the pain of the recession just like everyone else. And like the rest of the housing market, retirement homes and assisted-living centers are dealing with the pressure of the mortgage crisis, although they say there is some glimpse of improvement.

 

Vacancy rates are up at retirement homes and senior centers across the country. The occupancy rates reached the high 80s in some communities during the recession when they were once in the mid- to high 90s, according to the Assisted Living Federation of America.

 

Retirement communities are responding by offering extra financial incentive to help with the transition.

 

Some are offering services to help seniors sell their homes. Others have become more lenient on move-in fees and other financial help.

 

They have also had to play a larger role in easing people's fears. Many seniors and their families are afraid to make major financial changes in their lives because of the uncertainty of the economy.

 

"One thing we hear a lot from people is, " 'I can't afford it,' or 'I am just waiting this economy out,' " said Warren Naviasky, director of marketing and sales for Life Care Services, which owns the Blakehurst, North Oaks, Vantage House and Collington retirement communities in the Baltimore area.

 

Tom Neubauer, executive vice president for sales at Erickson Retirement Communities, said, "We are having to work harder, like every other business."

 

The trouble started for seniors when the stock market plummeted, sending the values of investment and retirement portfolios falling. Retirees were left with less money to live on. Housing prices also plunged. Retirees depending on selling their homes to finance a move into a retirement community suddenly found they wouldn't make enough of a profit to do that as home values fell.

 

Naviasky said the vacancy rates at Life Care Services properties vary depending on the area, but overall there has been a rise. He said some of the communities are offering reduced entrance fees and giving people more time to move in to lure retirees back to the market.

 

Erickson Retirement Communities began a "Realty and Moving Services" program two years ago in Michigan when the economy began to tank there because of the struggling auto industry. It expanded the program to the rest of its campuses, including two in the Baltimore area, as the economy worsened elsewhere.

 

The company has laid off more than 300 people since January and has halted new growth plans. It recently dropped plans to buy and develop up to 188 acres of historic Doughoregan Manor in Howard County as a 2,000-unit senior living complex.

 

The company said it has managed to turn reluctant seniors into Erickson residents with the moving program. Under the program, Erickson helps potential residents through the entire home-selling process, including staging the home, finding a real estate agent and appraising the home. The Realtors are able to help seniors price their home so it will sell. The company will also work to offer discounts on fees to make the math work.

 

"We're keeping customers from canceling their sale or getting cold feet and hitting the eject button," Neubauer said.

 

Lighthouse Senior Living, which has two centers in the area, said it is trying to make prospective buyers more aware of the incentives available, including a federal housing allowance for veterans. The company has also been more flexible with move-in fees.

 

Sharon Grosskopf, executive director at Lighthouse Senior Living, said that many of its potential buyers are living with family members who are choosing to keep them at home a little longer because of the economy.

 

"When you have a decision-maker afraid of losing their job or being underemployed, they're making the decision to have their family members stay at home a little longer," Grosskopf said.

 

Executives from the senior living communities said some seniors could afford to move into their communities, but talk of the economy makes them reluctant. The programs often help them realize they have more equity in their homes than they believed.

 

"Some folks do have significant equity in their home," Naviasky said. "They might not get what they could a couple of years ago, but houses are still selling. An important part of our process now is really to sit down and educate our clients."

 

The market has started to improve some, senior housing executives said. They have started to get more phone inquiries and people are seeming less anxious about the economy. The stock market has also started to improve, helping retirement portfolios.

 

"There certainly is some indication that things are loosening up," said Mark Pressman, executive director of North Oaks, which is owned by Life Care Services and where vacancy rates are up about 5 percent. "There is more movement than there was a year ago."

 

Copyright © 2009, The Baltimore Sun.

 

National / International

Swine Flu Campaign Waits on Vaccine

Only Third of Supply Is Expected for First Round of Vast Effort

 

By Rob Stein

Washington Post

Sunday, August 23, 2009

 

Government health officials are mobilizing to launch a massive swine flu vaccination campaign this fall that is unprecedented in its scope -- and in the potential for complications.

 

The campaign aims to vaccinate at least half the country's population within months. Although more people have been inoculated against diseases such as smallpox and polio over a period of years, the United States has never tried to immunize so many so quickly.

 

But even as scientists rush to test the vaccine to ensure it is safe and effective, the campaign is lagging. Officials say only about a third as much vaccine as they had been expecting by mid-October is likely to arrive by then, when a new wave of infections could be peaking.

 

Among the unknowns: how many shots people will need, what the correct dosage should be, and how to avoid confusing the public with an overlapping effort to combat the regular seasonal flu.

 

To prepare, more than 2,800 local health departments have begun recruiting pediatricians, obstetricians, nurses, pharmacists, paramedics and even dentists, along with a small army of volunteers from churches and other groups. They are devising strategies to reach children, teenagers, pregnant women and young and middle-aged adults in inner cities, suburban enclaves and the countryside.

 

"This is potentially the largest mass-vaccination program in human history," said Howard Markel, a professor of medical history at the University of Michigan who is advising the Centers for Disease Control and Prevention as it spearheads the effort.

 

Public health officials describe the effort as crucial to defend against the second wave of the Northern Hemisphere's first influenza pandemic in 41 years.

 

As schools reopen, the number of cases could jump sharply within weeks, sparking a second wave potentially far larger than the outbreak last spring. Although the swine flu appears no more dangerous than the typical seasonal flu, the new virus -- known as H1N1 -- is likely to infect many more people because most have no immunity against it.

 

The vaccine effort carries political risks for the Obama administration. "If the outbreak fizzles, they will be susceptible to being criticized for spending billions of dollars," said Harvey V. Fineberg, president of the National Academy of Sciences' Institute of Medicine, which advises Congress about medical issues. "On the other hand, if this outbreak is early and severe and there isn't enough vaccine, they'll be criticized for under-preparation."

 

Officials stress that they are proceeding cautiously. A final decision to move forward will not be made until they get the results of clinical trials -- testing to determine safety and dosing -- and assess the virus's threat. But officials are confident the vaccine will pass muster and expect a campaign will be launched as soon as manufacturers deliver the first vials.

 

"There's little doubt we're going to vaccinate people," said Anthony S. Fauci of the National Institute of Allergy and Infectious Diseases, who is leading the government's testing of the vaccine. "Who and when and exactly how -- we have to figure out."

 

The campaign is haunted by memories of the government's ill-fated 1976 effort to vaccinate against swine flu. The epidemic fizzled, but the vaccine was given to 40 million people and blamed for causing a rare paralyzing disorder known as Guillain-Barré Syndrome.

 

Another wild card will be whether the vaccine will be delivered with an "adjuvant" to boost its effectiveness or stretch limited supplies into more doses. Adjuvants have been used in Europe, but the Food and Drug Administration has not authorized their use in the United States.

 

"This is an overreaction," said Barbara Loe Fisher of the National Vaccine Information Center, which opposes many vaccine policies. "There is no national security threat here. Why are we operating like this? This is not polio. This is not smallpox."

 

Fears and misinformation about the vaccine are circulating, including inaccurate claims that it will be mandatory.

 

"I'm very concerned about the dangers of vaccines," said Janice Smith, 58, of Misawaka, Ind., who attended a public hearing Aug. 15, one of a series of meetings the CDC has sponsored to gauge public sentiment about the vaccine.

 

Authorities are adamant that vaccination will be voluntary, and they say there is no reason to think the vaccine will be any less safe than the usual flu vaccine. An adjuvant will be used only if necessary and proven safe, they say.

 

To address concerns of pregnant women and parents with young children, some vaccine is being produced without a mercury additive. And because the short-term studies can identify only common, immediate side effects, the CDC will step up monitoring for rarer, serious complications such as Guillain-Barré.

 

"We're putting into place systems that are as good as we can have to identify problems quickly if they do occur," CDC Director Thomas R. Frieden said.

 

On Friday, officials reported that no "red flags regarding safety" had emerged in the clinical trials. "We are continuing oversight on the quality and safety of the vaccine being produced, and the production process itself," said Jesse Goodman of the FDA. "That's going well so far, but our oversight is continuing."

 

In the meantime, local officials are drafting plans tailored to their communities. The shots in the arms and squirts up the nose will happen in schools, medical offices, hospitals, public health clinics, workplaces, drug stores and at mass vaccination events, possibly including drive-through clinics in parking lots where people would stick their arms out their car windows for a stab.

 

"It is clearly what we would call an all hands on deck," said James Blumenstock of the Association of State and Territorial Health Officials. "We're not starting from scratch, but we also don't have everything on the shelf that we can just pull off and put in place. It's a full-court press in moving forward to have everything in place when we're ready to go."

 

In Maryland, officials estimate that 2.9 million people fall into the priority groups for the vaccine; Virginia estimates the number at 2.5 million and the District at 225,000. The national total is about 159 million people.

 

Public health departments "have suffered from decades of neglect and are now facing a fiscal crisis in many places where they have had to lay staff off, or furlough staff or freeze hiring," Frieden said. "So H1N1 has not come at a particularly good time."

 

Setting priorities for delivering the vaccines will bring other complications. The elderly, usually first in line for flu shots, will not be this time because they seem more resistant to the virus. But they remain a top priority for the seasonal shots.

 

Schools considering giving shots to children are making plans to get permission from parents and have to determine how best to line up anxious, rambunctious students.

 

Everyone who gets a swine flu shot may need a booster several weeks later, potentially causing mix-ups about who got which shot when.

 

But Frieden and other outside observers expressed confidence that the program would be safe and successful.

 

The federal government has spent close to $2 billion to buy up to 195 million doses of vaccine and adjuvant, including the standard shots and the newer FluMist nasal spray vaccine made by MedImmune of Gaithersburg.

 

The government is prepared to buy enough to vaccinate every person -- 600 million doses all together -- if the pandemic or demand warrants it. That could increase the cost to $5 billion for the vaccine alone. It would cost at least $9 billion to administer the vaccine to the entire population, according to the Association of State and Territorial Health Officials.

 

Although five companies are racing to produce as much vaccine as possible, the first batches are not expected for two months, in part because the virus grew at about half the projected rate. Production appears to be increasing, but the first 45 million to 52 million doses -- about a third of what officials were anticipating -- won't be ready until mid-October, with about 20 million doses a week expected after that to continue the campaign through the winter.

 

Experts are uncertain whether they will face a shortage of vaccine because of high demand or will have plenty of vaccine but little interest.

 

"People's enthusiasm will depend largely on what they see happening around them," Fauci said. "If we get into the fall season and we don't see an explosion of cases, people will be less enthusiastic. If they see a lot of young people and kids getting sick, people will be very enthusiastic about getting vaccinated."

 

The CDC is formulating a $4.8 million multimedia campaign to encourage people to get vaccinated and help alleviate concerns and confusion, including radio and television public service announcements, print ads, and messages delivered via Twitter, RSS feeds and video podcasts on YouTube.

 

Although the vaccine will be free, providers could charge about $15 to administer it -- a fee that will be covered by Medicare and many health insurance plans.

 

Experts also worry the swine flu will divert attention from the seasonal flu, which can cause serious illness. Officials will launch the seasonal flu vaccine campaign Sept. 10 -- about a month early in the hopes of vaccinating as many people as possible before the swine flu campaign. The more people who get both vaccines, the less likely the swine flu virus will mingle with one of the others to produce a more dangerous mutant.

 

"We really don't want those ugly viruses mixing together," said Kim Elliott of the Trust for America's Health, a private nonprofit research and advocacy group.

 

Staff writers Rachel Saslow in Washington and Kari Lydersen in Chicago contributed to this report.

 

Copyright 2009 Washington Post.

 

Officials Weigh Circumcision to Fight H.I.V. Risk

 

By Roni Caryn Rabin

New York Times

Sunday, August 23, 2009

 

Public health officials are considering promoting routine circumcision for all baby boys born in the United States to reduce the spread of H.I.V., the virus that causes AIDS.

 

The topic is a delicate one that has already generated controversy, even though a formal draft of the proposed recommendations, due out from the Centers for Disease Control and Prevention by the end of the year, has yet to be released.

 

Experts are also considering whether the surgery should be offered to adult heterosexual men whose sexual practices put them at high risk of infection. But they acknowledge that a circumcision drive in the United States would be unlikely to have a drastic impact: the procedure does not seem to protect those at greatest risk here, men who have sex with men.

 

Recently, studies showed that in African countries hit hard by AIDS, men who were circumcised reduced their infection risk by half. But the clinical trials in Africa focused on heterosexual men who are at risk of getting H.I.V. from infected female partners.

 

For now, the focus of public health officials in this country appears to be on making recommendations for newborns, a prevention strategy that would only pay off many years from now. Critics say it subjects baby boys to medically unnecessary surgery without their consent.

 

But Dr. Peter Kilmarx, chief of epidemiology for the division of H.I.V./AIDS prevention at the C.D.C., said that any step that could thwart the spread of H.I.V. must be given serious consideration.

 

“We have a significant H.I.V. epidemic in this country, and we really need to look carefully at any potential intervention that could be another tool in the toolbox we use to address the epidemic,” Dr. Kilmarx said. “What we’ve heard from our consultants is that there would be a benefit for infants from infant circumcision, and that the benefits outweigh the risks.”

 

He and other experts acknowledged that although the clinical trials of circumcision in Africa had dramatic results, the effects of circumcision in the United States were likely to be more muted because the disease is less prevalent here, because it spreads through different routes and because the health systems are so disparate as to be incomparable.

 

Clinical trials in Kenya, South Africa and Uganda found that heterosexual men who were circumcised were up to 60 percent less likely to become infected with H.I.V. over the course of the trials than those who were not circumcised.

 

There is little to no evidence that circumcision protects men who have sex with men from infection.

 

Another reason circumcision would have less of an impact in the United States is that some 79 percent of adult American men are already circumcised, public health officials say.

 

But newborn circumcision rates have dropped in recent decades, to about 65 percent of newborns in 1999 from a high of about 80 percent after World War II, according to C.D.C. figures. And blacks and Hispanics, who have been affected disproportionately by AIDS, are less likely than whites to circumcise their baby boys, according to the agency.

 

Circumcision rates have fallen in part because the American Academy of Pediatrics, which sets the guidelines for infant care, does not endorse routine circumcision. Its policy says that circumcision is “not essential to the child’s current well-being,” and as a result, many state Medicaid programs do not cover the operation.

 

The academy is revising its guidelines, however, and is likely to do away with the neutral tone in favor of a more encouraging policy stating that circumcision has health benefits even beyond H.I.V. prevention, like reducing urinary tract infections for baby boys, said Dr. Michael Brady, a consultant to the American Academy of Pediatrics.

 

He said the academy would probably stop short of recommending routine surgery, however. “We do have evidence to suggest there are health benefits, and families should be given an opportunity to know what they are,” he said. But, he said, the value of circumcision for H.I.V. protection in the United States is difficult to assess, adding, “Our biggest struggle is trying to figure out how to understand the true value for Americans.”

 

Circumcision will be discussed this week at the C.D.C.’s National H.I.V. Prevention Conference in Atlanta, which will be attended by thousands of health professionals and H.I.V. service providers.

 

Among the speakers is a physician from Operation Abraham, an organization based in Israel and named after the biblical figure who was circumcised at an advanced age, according to the book of Genesis. The group trains doctors in Africa to perform circumcisions on adult men to reduce the spread of H.I.V.

 

Members of Intact America, a group that opposes newborn circumcision, have rented mobile billboards that will drive around Atlanta carrying their message that “circumcising babies doesn’t prevent H.I.V.,” said Georganne Chapin, who leads the organization.

 

Although the group’s members oppose circumcision on broad philosophical and medical grounds, Ms. Chapin argued that the studies in Africa found only that circumcision reduces H.I.V. infection risk, not that it prevents infection. “Men still need to use condoms,” Ms. Chapin said.

 

In fact, while the clinical trials in Africa found that circumcision reduced the risk of a man’s acquiring H.I.V., it was not clear whether it would reduce the risk to women from an infected man, several experts said.

 

“There’s mixed data on that,” Dr. Kilmarx said. But, he said, “If we have a partially successful intervention for men, it will ultimately lower the prevalence of H.I.V. in the population, and ultimately lower the risk to women.”

 

Circumcision is believed to protect men from infection with H.I.V. because the mucosal tissue of the foreskin is more susceptible to H.I.V. and can be an entry portal for the virus. Observational studies have found that uncircumcised men have higher rates of other sexually transmitted diseases like herpes and syphilis, and a recent study in Baltimore found that heterosexual men were less likely to have become infected with H.I.V. from infected partners if they were circumcised.

 

Copyright 2009 Washington Post.

 

Opinion

Seniors hit hard on health care

 

Carroll County Times Letter to the Editor

Sunday, August 23, 2009

 

Editor:

 

On the opinion page of Monday’s Carroll County Times was a cartoon showing a senior holding a sign that read “No to Government run health plan,” and next to it the same senior holding a sign that read “Don’t touch my Medicare.”

 

This is just another attempt by liberals to paint the average American as being dumb. Medicare is not the plan that everyone jumps into. First, when you reach age 65, you have very little choice to go into this plan. Let me explain, if you already have health insurance and you elect not to take the Medicare option (government option) your insurance company will not pay for the portion that Medicare would have covered, even though you have paid the full premium due. You have to pay the difference out of pocket.

 

If you elect to reapply for the Medicare option, you have to pay a penalty for not enrolling when you turned 65 or became disabled. This penalty is an increase in the premium that the government withholds from your Social Security checks to pay for health care (Medicare). The minimum amount is $96.40.

 

An example is a couple that has insurance and pays $190 a month for their coverage. Once they enrolled in Medicare their premium drops to $129.50 a month. You still need insurance because Medicare does not cover the full bill because of a lot of exclusions. It sounds good, but it is not because money is withheld from their Social Security check in the amount of $220. Now their total premium is approximately $350 per month instead of $190.

 

The current argument by the White House is that if you like your insurance you can keep your insurance. It will be just like Medicare. Employers will drop you, no insurance, or the insurance companies will disappear. Washington is not and will not listen to the citizens of this country. If you want real change then vote all the politicians out, press for term limits and the maybe we can put this country back on track.

 

Charles Laster

Westminster

 

Copyright 2009 Carroll County Times.

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