April22

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‘Scary’ Lung Disease Now Afflicts More Women Than Men In U.S. Joan Cousins was among a generation of young women who heard — and bought into the idea — that puffing on a cigarette was sophisticated, modern, even liberating. No one suspected it would make them more than equal to men in suffering a choking, lifeshortening lung disease. “Everybody smoked. It was the cool thing to do,” said Cousins, who smoked her first cigarette 67 years ago at age 16. But one day, Cousins started coughing and could not stop — or take a deep breath. She drove to a hospital, where doctors told her she had a progressive lung disease called chronic

obstructive pulmonary disease (COPD). “Not breathing was so scary … that I never had another cigarette,” Cousins said. COPD traditionally was considered a man’s disease, but it now kills more women in the United States than men. Women account for 58 percent of the14.7 million people in the U.S. living with the disease and 53 percent of those who die from it, according to the American Lung Association. Nearly 8 percent of women in the U.S. have reported a COPD diagnosis, compared with just under 6 percent of men. “It’s a huge public health problem for women that doesn’t really get enough attention,” said

Dr. Meilan Han, associate professor of medicine at the University of Michigan. “This is one of the top killers of women in the country.” Because COPD is often associated with men, women are frequently diagnosed after the disease is already advanced. Symptoms of COPD include a chronic cough, wheezing, tightening of the chest and shortness of breath. There is no cure for COPD, but its progression can be slowed. The most important thing a patient can do after a COPD diagnosis is to stop smoking. Researchers largely blame women’s gradual adoption of smoking for the modern-day rise in COPD deaths among

women. Men started smoking in large numbers in the late 1800s, coinciding with the mass production of cigarettes. In the 1920s and 1930s, tobacco companies began targeting women with ads that appealed to their sense of independence and yearning for social and sexual desirability. Another wave of ad campaigns in the late 1960s and early 1970s induced large numbers of women, and teenage girls, to start smoking cigarettes. Brands such as Virginia Slims capitalized on the women’s liberation movement with catchy slogans, including “You’ve come a long way, baby.” ...Read More

A Tale Of Two CT Scanners — One Richer, One Poorer Benjamin Hynden, a financial adviser in Fort Myers, Fla., hadn’t been feeling well for a few weeks last fall. He’d had pain and discomfort in his abdomen. In October, he finally made an appointment to see his doctor about it. “It wasn’t severe,” he said. “It was just kind of bothersome. It just kind of annoyed me during the day.” The internist, Dr. John Ardesia, checked him out and referred him for a CT scan at a nearby imaging center. The radiologist didn’t see anything wrong on the images, and

Ardesia didn’t recommend any treatment. A few weeks later, Hynden, who has a high-deductible health insurance policy with Cigna, got a bill for $268. He paid it and moved on. But three months later, in midJanuary, Hynden was still feeling lousy. He called up Ardesia’s office again. This time, the doctor wasn’t available. A nurse practitioner, concerned that Hynden might be suffering from appendicitis, advised him to go to the hospital right away. “I was a little worried,”

Hynden recalled. “When he told me to go to the ER, I felt compelled to take his advice.” Hynden arrived later that morning at Gulf Coast Medical Center, one of several hospitals owned by Lee Health in the Fort Myers area. The triage nurse told him the problem wasn’t his appendix, but she suggested he stick around for some additional tests — including another CT scan — just to be safe. “It was the exact same machine. It was the exact same test,” Hynden said. The results were also the same as the October scan: Hynden

was sent home without a definitive diagnosis. And then the bill came. Patient: Benjamin Hynden, 29, a financial adviser in Fort Myers, Fla. Total Bill: $10,174.75, including $8,897 for a CT scan of the abdomen Service Provider: Gulf Coast Medical Center, owned by Lee Health, the dominant health care system in southwest Florida….Read More

Federal Appeals Court Puts Chill On Maryland Law To Fight Drug Price-Gouging States continue to battle budgetbusting prices of prescription drugs. But a federal court decision could limit the weapons available to them — underscoring the challenge states face as they, in the absence of federal action, go

one-on-one against the powerful drug industry. The 2-to-1 ruling Friday by the U.S. 4th Circuit Court of Appeals invalidated a Maryland law meant to limit “price-gouging” by makers of generic drugs. The measure was inspired by cases such as that of former Turing Pharmaceutical CEO Martin Shkreli, who raised one generic’s price 5,000

percent after buying the company. The law, which had been hailed as a model for other states, is one of a number of state initiatives designed to combat rapidly rising drug prices. It gave the state attorney general power to intervene if a generic or off-patent drug’s price increased by 50 percent or more in a single year.

If dissatisfied with the company’s justification, the attorney general could have filed suit in state court. Manufacturers would have faced a fine of up to $10,000 and potentially have to reverse the price hike. The generics industry was fiercely critical of the law….Read More

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