The Online Resource for Massachusetts Poverty Law Advocates

Feed aggregator

¿Quiere vivir 100 años y disfrutarlos? Estos centenarios comparten sus secretos

Kaiser Health News - 18 min 58 sec ago

Gertrude Siegel tiene 101 años y siempre le preguntan el secreto. “Todo el mundo dice: ‘Quiero ser como tú’. Les digo que se pongan en la fila”, contó.

John y Charlotte Henderson, de 104 y 102 respectivamente, a menudo contestan preguntas de ansiosos aspirantes a centenarios.

“Vive con moderación”, aconsejan. “Nunca exageres nada. Come bien. Duerme bien. No bebas demasiado. No comas en exceso. Y haz ejercicio regularmente”.

Mac Miller, que tiene 102 años, tiene una respuesta estándar.

Use Nuestro ContenidoEste contenido puede usarse de manera gratuita (detalles).

“La gente me pregunta” ¿Cuál es el secreto? “La respuesta es simple. La familia que te toca”, ironiza.

La genética y los comportamientos juegan su papel en determinar por qué algunas personas llegan, o superan, los 100 años, mientras que otras no, pero no hay garantías. Y ahora, a medida que un número cada vez mayor de personas alcanza los tres dígitos, descubrir los misterios de la longevidad ha adquirido una nueva importancia para los investigadores.

Aunque las personas de 100 años y más componen un segmento minúsculo de la población de los Estados Unidos, los informes del Censo muestran que las filas de centenarios se están engrosando. Entre 1980 y 2010, los números subieron de 32.194 a 53.364, un aumento de casi 66%. El estimado más reciente de población, publicado en julio de 2015, refleja que hay 76.974 centenarios.

John y Charlotte Henderson, de 104 y 102 años, están juntos hace 77. Viven de manera independiente en un complejo para seniors en Austin Texas. (Sharon Jayson para KHN)

“El número de centenarios en los Estados Unidos, y otros países, se ha venido duplicando aproximadamente cada ocho años”, dijo James Vaupel, director fundador del Instituto Max Planck de Investigación Demográfica en Rostock, Alemania.

“Cuando impacten los baby boomers (personas que nacieron después de la Segunda Guerra Mundial), habrá una aceleración, y la cifra podría estar duplicándose cada cinco o seis años”, dijo.

Henderson y su esposa por 77 años viven en Austin en la sección independiente de Longhorn Village, una comunidad de más de 360 ancianos, muchos de los cuales tienen vínculos con la Universidad de Texas en Austin. Henderson, quien llegó en 1932 como estudiante de primer año, es el jugador de fútbol americano más antiguo de la UT. Son los únicos centenarios en el complejo y son una raza rara: los centenarios casados.

Charlotte Henderson dijo que cree que estar casada la puede haber ayudado a superar la barrera de los 100 años.

“La pasamos muy bien cuando John se retiró. Viajamos mucho”, contó. “Nos mantenemos ocupados todo el tiempo, y estoy segura de que eso ayuda”.

Bernard Hirsh, de 100 años, quien vive en Dallas, está de acuerdo. Su esposa, Bee, tiene 102. Se casaron en 1978 cuando ambos estaban en sus sesentas, y cada uno había enviudado, ella por segunda vez.

“Creo que ha sido un matrimonio maravilloso, y nos hemos beneficiado el uno al otro”, dijo.

Existe poca investigación sobre los efectos del matrimonio en la longevidad. Un estudio belga de 2015 sobre los centenarios nacidos entre 1893 y 1903 se centró en sus condiciones de vida durante los 60 y 100 años. El estudio encontró que “en la vejez, vivir con un cónyuge es beneficioso para los hombres, pero no para las mujeres, para quienes vivir solas es más ventajoso que vivir en pareja”.

El estudio explicó que “vivir con el cónyuge en edades más avanzadas no proporciona el mismo nivel de protección que a edades más jóvenes. Esto puede explicarse por la disminución de la salud del cuidador a medida que aumentan las necesidades de su cónyuge. La prestación de cuidados también podría tener consecuencias negativas para la salud y la condición económica del cónyuge que es el principal proveedor de atención, especialmente para las mujeres mayores”.

Sin embargo, Vaupel, quien dirige la Red Internacional de Investigación sobre Envejecimiento del Instituto, dijo que estar casado es positivo para ambos.

Foto familiar de John y Charlotte. (Cortesía de la familia Henderson)

“Especialmente si usted es bastante viejo, es muy útil tener un cónyuge. Si eres muy viejo y no tienes un cónyuge, la probabilidad de muerte es mayor”, dijo.

Siegel, quien vive en una comunidad para adultos mayores en Boca Raton, Florida, sobrevivió a dos maridos. Ella nunca fumó y ocasionalmente toma un vaso de vino tinto seco.

“No soy una gran comedora. Y no como mucha carne “, dijo Siegel, quien dijo que pesa 90 libras y solía medir 5 pies de altura, pero se está encogiendo.

Ella permanece activa caminando dentro del edificio aproximadamente una media hora cada día, jugando bridge dos veces por semana y haciendo ejercicio.

“Siento que eso es lo que realmente mantuvo mi cuerpo bastante bien. No fue el deporte. Fue hacer ejercicio”, dijo de la rutina que practica dos veces al día durante unos 20 minutos.

Miller, de Pensacola, Florida, también sobrevivió a dos esposas.

Fue piloto de combate en el Cuerpo de Marines durante la Segunda Guerra Mundial y pasó ocho años en servicio activo, lo que, explicó Miller, “no fue tan bueno para mí porque me senté en la cabina de un avión durante 5.000 horas”.

Pero fue un joven activo: hizo atletismo, jugo fútbol americano y pasó horas practicando surf mientras vivió en Honolulu, Hawaii.

Miller está “libre de gluten” debido a las alergias y no come muchos carbohidratos. Él jamás fumó. Y, todavía disfruta de un whisky a la noche.

Los Henderson suelen tener una copa de vino o un cóctel antes de la cena. Ella nunca fumó. Él dejó en 1950.

Hirsh, de Dallas, otro no fumador, atribuye su larga vida a la “buena suerte”.

“Yo fui muy activo en mi negocio y caminaba mucho durante el día. No fui sedentario”, dijo.

Ahora, el ejercicio se limita a “alguna elongación de rodillas cada mañana para mantener fuertes mis piernas”.

“Mi padre murió de un ataque al corazón a los 50 años, y mi madre murió a los 60 años de un accidente cerebrovascular, así que no creo que mis genes fueran muy buenos”, dijo Hirsh.

El geriatra Thomas Perls, director del New England Centenarian Study en el Boston Medical Center, dijo que las investigaciones muestran que las conductas tienen una mayor influencia en la supervivencia hasta finales de los 80, ya que dijo que la mayoría de las personas tienen los genes adecuados para alcanzar esa meta de edad, siempre y cuando sus conductas no sean dañinas. Pero una vez que la gente llega a los 90 y los pasa, la genética juega un papel más significativo.

John Henderson, de 104 años, dice que el secreto de la larga vida es “vivir con moderación”. (Sharon Jayson para KHN)

“Para llegar a estas edades tan altas, realmente tienes que tener los genes adecuados en algún rincón”, dijo.

Como líder internacional en este campo, Perls se centra en encontrar la combinación correcta de comportamiento, medio ambiente y genética para producir una larga vida. Su trabajo incluye un estudio del Instituto Nacional sobre el Envejecimiento llamado Long Life Family Study.

“Siempre hay preguntas sobre el medio ambiente versus los genes”, dijo el endocrinólogo Nir Barzilai, director fundador del Instituto para la Investigación del Envejecimiento del Colegio Albert Einstein de Medicina en el Bronx, Nueva York. “Estamos con nuestros genes en este medio ambiente. Es realmente 50-50, no importa cómo lo mires”.

Los estudios de Barzilai incluyen a los centenarios y a sus hijos, así como esfuerzos para frenar el proceso de envejecimiento.

Perls dijo que su investigación, la de Barzilai y la de otros, han encontrado ciertos puntos en común entre los que alcanzaron el hito de los 100 años: poco tabaco, casi todos los hombres son delgados, y los centenarios tienen altos niveles de “colesterol bueno”. “Los estudios demuestran que cualquiera sea su nivel de estrés, lo manejan bien. Y están relacionados con otros centenarios o tienen un padre o abuelo que vivió más de 80 años”.

Estas lecciones de larga vida están teniendo una influencia positiva sobre el público, que ha hecho cambios para mejor en el siglo XXI, dijo Vaupel.

“No fumamos ni bebemos tanto, y somos mejores haciendo ejercicio. La gente se está cuidando mejor. Las personas están mejor educadas, y los más educados saben cuándo ir al médico y seguir el consejo del médico”, dijo, agregando que la gente ahora tiende a tener mayores ingresos y puede gastar más en atención médica y en mejores dietas.

“Lo más importante es que vivimos más tiempo y vivimos más sanos”, dijo Vaupel.

Categories: Health Care

An Interview with Sarah Cooper, Scholar-in-Residence

In Custodia Legis - 2 hours 15 min ago

Law Library Scholar-in-Residence Sarah Cooper visits the Supreme Court of the United States. Photo by Paul Cooper.

This week’s interview is with Dr. Sarah Cooper, the Law Library scholar-in-residence.  Dr. Cooper made extensive use of the Law Library’s collection to conduct research for her next book.  During her short time here, Dr. Cooper significantly changed the structure of her book due to the materials she discovered at the Library.

Describe your background.

I am an academic at Birmingham City University’s School of Law in the United Kingdom, where I am the Director of the Centre for Law, Science and Policy. The centre focuses on research projects that examine intersections of law with various sciences and technologies. My research in particular examines U.S. court approaches to scientific uncertainty in the criminal justice process. I also teach English criminal law, American criminal procedure and evidence, and oversee our moot court teams and US internship program.

What is your academic/professional history?

After completing my English law degree (LL.B) with a minor in American Legal Studies, I qualified as a barrister under a Lord Denning Scholarship at The Honorable Society of Lincoln’s Inn. I then joined Birmingham City University as an academic and completed postgraduate awards both in higher education and international justice. I completed my PhD which examined the influence of legal process theory on U.S. courts addressing scientific uncertainty in 2016. I am a Fellow of the Higher Education Authority in the U.K. and the Arizona Justice Project in the U.S.

How would you describe your job (or research project) to other people?

Whilst a scholar-in-residence, I am gathering research material in order to shape a book that I am writing. The book is provisionally titled “Forensic Science in America’s Era of Innocence” and it examines how law, science, and innocence intersect at key junctures in the criminal justice process. I argue that obstacles to identifying and remedying wrongful conviction, which manifest at these junctures (and are associated with legal procedures and rules, social actors, and scientific practices and evidence), can be attributed (in a not so insignificant way) to deeper philosophical clashes between the enterprises of science and law. It focuses on the time period between 1985-present.

Why did you want to work at the Law Library?

I wanted to undertake research at the Law Library of Congress because of its unrivalled collection of fantastic materials and beautiful setting!

What is the most interesting fact you’ve learned about the Law Library of Congress?

Generally, I am astounded at the volume of materials that can be accessed at the Library. I’m discovering things I never knew existed almost every day! More specifically, the most interesting thing I’ve encountered at the Library of Congress is Thomas Jefferson’s Library. The story behind that collection is fascinating.

What’s something most of your co-workers do not know about you?

At the LOC? Folks probably wouldn’t guess that I am an avid soccer fan. There’s little I can’t talk about when it comes to soccer teams! I have been a season ticket holder at Aston Villa Football Club for many years, and you can often find me running in my number ‘5’  Villa jersey.

Categories: Research & Litigation

Those Indecipherable Medical Bills? They’re One Reason Health Care Costs So Much.

Medicare -- New York Times - 5 hours 15 min ago
Hospitals have learned to manipulate medical codes — often resulting in mind-boggling bills.
Categories: Elder, Medicare

March Madness Vasectomies Encourage Guys To Take One For The Team

Kaiser Health News - 6 hours 15 min ago


Doctors say it all started eight years ago, when a urology clinic in Oregon ran an ad promoting the benefits of scheduling a vasectomy in March.

“You go in for a little snip, snip and come out with doctor’s orders to sit back and watch nonstop basketball,” the voice-over promised. “If you miss out on this, you’ll end up recovering during a weekend marathon of ‘Desperate Housewives’!”

Copycat ads followed. Now a sports radio show in Washington, D.C., has an annual Vasectomy Madness contest, where the prize is a free vasectomy.

Here’s how it works: Three guys come on the air to make their cases for getting snipped. The announcers ruthlessly roast them, and then listeners vote on their favorite.

“All right, let’s bring in our next contestant,” a host said. “I believe it’s Abe from Warrenton, Va. So tell us your story. Why are you here?”

Abe has three kids, ages 9, 6 and 3.

“Another one — surprise! Due in July,” Abe said. “I was shopping after the third for a vasectomy and, like a dope, dragged my feet.”

This story is part of a partnership that includes KQED, NPR and Kaiser Health News. It can be republished for free. (details)

There’s Mike, also expecting his fourth child — also a surprise.

“My wife and I have had enough,” he pleaded. “We need help to stop the flow.”

And then there’s Charles.

“Four kids. Three different women,” Charles said, inspiring a roar of jeers from the hosts.

Procrastination can be so common with the “Big V” that it takes a panel of sports jocks offering a free procedure for some guys to finally let a doctor take a scalpel to their nether regions.

That may be one reason vasectomy rates are low: About 5 percent of women rely on their partner’s vasectomy for contraception, unchanged from a decade ago. The Centers for Disease Control and Prevention’s National Survey of Family Growth compares that to 20 percent of women who have had a sterilization procedure, even though women’s surgery is more invasive and more expensive.

“Men are culturally the providers. It’s hard for them to seek care,” said Dr. Paul Turek, a California urologist. “They don’t know how to be a patient.”

Turek has clinics in San Francisco and Beverly Hills. He sees an uptick in vasectomy visits during March Madness, and he’s also noticed more guys coming in together.

“One group came in from a tech company in a limousine,” he said.

Last year, five college buddies scheduled a group vasectomy in March. They live all over the U.S. now, and one of them had an idea to reunite in San Francisco and undergo the outpatient procedure together.

“I gave ’em a deal,” Turek said. “I closed the doors. We had sports TV on. They were having fun.”

As each guy returned to the waiting room, he was greeted with fist bumps and high-fives. Then the men hobbled back to their hotel to bet on the games and yell at the television together.

Turek made an interesting observation during that bro basketball weekend: The friends seemed to recover faster than his typical patients.

“They had no complaints,” he said. “They were back at work sooner. They took fewer pain pills. It was the best anesthesia, having their buddies with them.”

Turek gives all his vasectomy patients a certificate of honor for “uncommon bravery and meritorious performance.”

There is another theory about why vasectomies aren’t more popular: the cost. The Affordable Care Act requires insurers to cover contraceptives without charging out-of-pocket costs. But vasectomies weren’t included in the rule. The procedure costs about $500, but some doctors charge up to $1,000.

That’s why Charles subjected himself to the free vasectomy contest at the D.C. radio station. His insurance covers a portion of the procedure, “but I’d still have to pay my deductible, which is, like, a thousand bucks.”

Vasectomy was overlooked in Obamacare because, under the law, birth control was considered a women’s health service.

“Right now the policy says to a couple: Your insurance will cover birth control without any out-of-pocket costs on your end, as long as it’s the woman who’s using it,” says Adam Sonfield, senior policy manager at the Guttmacher Institute.

Last year, 12,000 people signed a petition asking regulators to cover vasectomy without cost sharing. Doctors’ groups even drafted language to this effect to add to the regulations.

But when the Trump administration took over, it told the groups to stop trying, according to Aaron Hamlin, executive director of the Male Contraception Initiative.

“The birth control benefit has been under pretty much continual political attack since the ACA was enacted,” said Sonfield.

So for now that leaves guys like Charles, Mike and Abe vying for a free March Madness vasectomy. The winner in the end?

Abe — one of the guys expecting his fourth child.

His prize came with a catch, though. He will have to let one of the sportscasters come to his appointment, to broadcast a “play-by-play.”

This story is part of a partnership that includes KQED, NPR and Kaiser Health News.

Categories: Health Care

On The Air With KHN: What’s Next For The Affordable Care Act?

Kaiser Health News - Tue, 03/28/2017 - 4:43pm

On Friday, House Republican leaders failed to secure enough support to pass their plan to repeal and replace the Affordable Care Act. Reporters with Kaiser Health News and California Healthline (produced by KHN) have appeared on numerous radio and television shows in recent days to assess what’s next for the health law. Listen to what they had to say below.

National Media

NPR’s All Things Considered with Mary Agnes Carey (March 25):

CNN’s Smerconish with Mary Agnes Carey (March 25):

WBUR’s On Point with Mary Agnes Carey (March 27):

https://kaiserhealthnews.files.wordpress.com/2017/03/032717-on-point_carey.mp3

WAMU’s 1A with Julie Rovner (March 27):

Click here to listen to the segment.

WBUR’s Here & Now with Julie Rovner (March 27):

https://kaiserhealthnews.files.wordpress.com/2017/03/032717-here-now_rovner.mp3

PBS NewsHour with Mary Agnes Carey (March 27):

California Media

KCRW’s The Mixer with Anna Gorman (March 24):

https://kaiserhealthnews.files.wordpress.com/2017/03/032417-kcrw_gorman.mp3

KQED’s The California Report with Pauline Bartolone (March 27):

https://kaiserhealthnews.files.wordpress.com/2017/03/032717-kqed_bartolone.mp3

KPCC’s Air Talk with Chad Terhune (March 27):

https://kaiserhealthnews.files.wordpress.com/2017/03/032717-kpcc_terhune.mp3
Categories: Health Care

Justice Department Joins Lawsuit Alleging Massive Medicare Fraud By UnitedHealth

Kaiser Health News - Tue, 03/28/2017 - 2:07pm

The Justice Department has joined a California whistleblower’s lawsuit that accuses insurance giant UnitedHealth Group of fraud in its popular Medicare Advantage health plans.

Justice officials filed legal papers to intervene in the suit, first brought by whistleblower James Swoben in 2009, on Friday in federal court in Los Angeles. On Monday, they sought a court order to combine Swoben’s case with that of another whistleblower.

Swoben has accused the insurer of “gaming” the Medicare Advantage payment system by “making patients look sicker than they are,” said his attorney, William K. Hanagami. Hanagami said the combined cases could prove to be among the “larger frauds” ever against Medicare, with damages that he speculates could top $1 billion.

UnitedHealth spokesman Matt Burns denied any wrongdoing by the company. “We are honored to serve millions of seniors through Medicare Advantage, proud of the access to quality health care we provided, and confident we complied with program rules,” he wrote in an email.

This KHN story also ran on NPR. It can be republished for free (details).

Burns also said that “litigating against Medicare Advantage plans to create new rules through the courts will not fix widely acknowledged government policy shortcomings or help Medicare Advantage members and is wrong.”

Medicare Advantage is a popular alternative to traditional Medicare. The privately run health plans have enrolled more than 18 million elderly and people with disabilities — about a third of those eligible for Medicare — at a cost to taxpayers of more than $150 billion a year.

Although the plans generally enjoy strong support in Congress, they have been the target of at least a half-dozen whistleblower lawsuits alleging patterns of overbilling and fraud. In most of the prior cases, Justice Department officials have decided not to intervene, which often limits the financial recovery by the government and also by whistleblowers, who can be awarded a portion of recovered funds. A decision to intervene means that the Justice Department is taking over investigating the case, greatly raising the stakes.

“This is a very big development and sends a strong signal that the Trump administration is very serious when it comes to fighting fraud in the health care arena,” said Patrick Burns, associate director of Taxpayers Against Fraud in Washington, a nonprofit supported by whistleblowers and their lawyers. Burns said the “winners here are going to be American taxpayers.”

Burns also contends that the cases against UnitedHealth could potentially exceed $1 billion in damages, which would place them among the top two or three whistleblower-prompted cases on record.

“This is not one company engaged in episodic bad behavior, but a lucrative business plan that appears to be national in scope,” Burns said.

On Monday, the government said it wants to consolidate the Swoben case with another whistleblower action filed in 2011 by former UnitedHealth executive Benjamin Poehling and unsealed in March by a federal judge. Poehling also has alleged that the insurer generated hundreds of millions of dollars or more in overpayments.

When Congress created the current Medicare Advantage program in 2003, it expected to pay higher rates for sicker patients than for people in good health using a formula called a risk score.

But overspending tied to inflated risk scores has repeatedly been cited by government auditors, including the Government Accountability Office. A series of articles published in 2014 by the Center for Public Integrity found that these improper payments have cost taxpayers tens of billions of dollars.

“If the goal of fraud is to artificially increase risk scores and you do that wholesale, that results in some rather significant dollars,” Hanagami said.

David Lipschutz, senior policy attorney for the Center for Medicare Advocacy, a nonprofit offering legal assistance and other resources for those eligible for Medicare, said his group is “deeply concerned by ongoing improper payments” to Medicare Advantage health plans.

These overpayments “undermine the finances of the overall Medicare program,” he said in an emailed statement. He said his group supports “more rigorous oversight” of payments made to the health plans.

The two whistleblower complaints allege that UnitedHealth has had a practice of asking the government to reimburse it for underpayments, but did not report claims for which it had received too much money, despite knowing some these claims had inflated risk scores.

The federal Centers for Medicare & Medicaid Services said in draft regulations issued in January 2014 that it would begin requiring that Medicare Advantage plans report any improper payment — either too much or too little.

These reviews “cannot be designed only to identify diagnoses that would trigger additional payments,” the proposal stated.

But CMS backed off the regulation’s reporting requirements in the face of opposition from the insurance industry. The agency didn’t say why it did so.

The Justice Department said in an April 2016 amicus brief in the Swoben case that the CMS decision not to move ahead with the reporting regulation “does not relieve defendants of the broad obligation to exercise due diligence in ensuring the accuracy” of claims submitted for payment.

The Justice Department concluded in the brief that the insurers “chose not to connect the dots,” even though they knew of both overpayments and underpayments. Instead, the insurers “acted in a deliberately ignorant or reckless manner in falsely certifying the accuracy, completeness and truthfulness of submitted data,” the 2016 brief states.

The Justice Department has said it also is investigating risk-score payments to other Medicare Advantage insurers, but has not said whether it plans to take action against any of them.

Categories: Health Care

Vouchers Work: Helping Vulnerable People Afford Decent, Stable Housing

Center on Budget and Policy Priorities - Tue, 03/28/2017 - 1:50pm

This is the first in our “Vouchers Work” blog series, which provides the latest facts and figures about the Housing Choice Voucher program, the largest rental assistance program to help families with children, working people, seniors, and people with disabilities afford decent, stable housing.

Categories: Benefits, Poverty

GOP So Far Failing to Keep Three “Tax Reform” Promises

Center on Budget and Policy Priorities - Tue, 03/28/2017 - 1:03pm

President Trump and House Speaker Paul Ryan have both signaled that tax reform is their next top legislative priority. Any tax bill should keep three promises that they and other key Republican leaders have made:

(1) No absolute tax cuts for the “upper class.” In an interview shortly after his nomination, Treasury Secretary Steven Mnuchin stated:

Categories: Benefits, Poverty

Pages

Subscribe to Mass Legal Services aggregator

Limit Offer