What's Your Best Defense Against Swine Flu?

Tamiflu? Swine flu vaccine? A mask?

If only it were that easy ...

Unfortunately, popping a pill or rolling up your sleeve isn't the key. In this case, you are your own best bet for preventing yourself -- and others -- from getting swine flu.

While government health officials are preparing for the rise in swine flu cases that's likely to come, their most effective strategy -- the swine flu vaccine -- won't help much until late November.

We can't wait until then because swine flu cases are already on the rise with school starting and the cooler weather on the way.

So how far away do you need to stay away from sick people? Do you need a face mask? What should you do if you suspect you or something else has swine flu?

Here's your two-step plan.

The first part of the plan is to avoid infection:

• Wash your hands frequently and thoroughly. Use soap and warm water when available; use hand sanitizer between hand washings.
• Avoid close contact with sick people. Close contact means getting within 6 feet of a sick person. If you must care for someone who is ill, minimize close contact.
• It's not known whether face masks protect against infection. If you use one, don't slack off on hand washing or avoiding close contact with sick people. Use the face mask properly and throw it away after use.
• Get your seasonal flu vaccine as soon as possible. It's safe, and it protects against the three seasonal flu bugs expected to circulate this fall and winter -- even though it won't protect against H1N1 swine flu.

The second part of the plan is to keep from spreading the swine flu virus:

• Stay home if you are sick.
• Observe flu etiquette. Don't cough or sneeze into your hands. Cough/sneeze into a tissue -- or, failing that, your elbow.
• If you can do so comfortably, wear a face mask if you come into contact with others.
• If you are an employer, do not penalize workers for staying home if sick or for caring for sick children.
• Make plans -- now -- for what you'd do if you or your children get sick this fall.

Spread the word. The key to this working is all of us jumping on board. While it may not feel like you have the power to make much of a difference in combating the swine flu pandemic, you do!

So, tell the truth. Are you doing anything different to help prevent spread of swine flu or do you think it's a bunch of hogwash?

Health Care Reform: Myths vs. Facts

By Andy Miller
WebMD Guest Blogger

August has turned into a month of myth-making on health reform.

Half-truths, distortions, and downright falsehoods have mixed freely with the facts in the incendiary debate, stoked by town hall meetings, talk radio, and the Internet.

Misinformation can travel as fast as email. Some unfounded rumors have received mainstream attention, such as former vice-presidential candidate Sarah Palin's claim that ''death panels'' would encourage euthanasia. Another widely circulated myth: Bureaucrats would deny care to a person going blind in one eye if the other eye functions normally.

Neither side in the battle appears to have a perfect truth-telling score. Here's a look at the facts behind several claims about reform:

CLAIM: The health care reform bill does this and that…

THE FACTS: There isn't just one bill. The Senate has produced one, and the House has created another version. Yet another bill is expected to emerge soon from the Senate Finance Committee, and it may look very different from the others. The legislative process has many miles to go before each chamber enacts a final version of reform -- if it gets that far. Reform opponents, meanwhile, may have an advantage in that it's easier to make charges about a moving target -- or targets.

CLAIM: The Democrats' health reform will require counseling sessions that will encourage seniors on how to end their life sooner.

THE FACTS: The noisiest fact-defying issue of all. The House legislation would let Medicare reimburse doctors for their time if seniors choose to consult them on end-of-life issues, such as making a living will or hospice care. There's no requirement for Medicare members to do this; it's voluntary. The reform legislation has nothing regarding euthanasia. AARP's John Rother says rumors that suggest the provision calls for government to encourage euthanasia 'is a gross, and even cruel, distortion -- especially for any family that has been forced to make the difficult decisions on care for loved ones approaching the end of their lives.''

CLAIM: Health care reform will lead to rationing of medical services, and the government will decide what care people get.

THE FACTS: Plenty of rationing already exists in the health care system. Insurance companies and employer benefit plans often limit a person's choices of medical services. For the uninsured, elective procedures are difficult to get, if not impossible. But reform would specifically bar some forms of rationing: Insurers would no longer discriminate against an individual with a pre-existing medical condition.

The rationing argument ignited when former New York Lt. Gov. Betsy McCaughey wrote in an opinion piece that government research comparing the effectiveness of medical treatments would eventually limit seniors' access to services.

But FactCheck.org says the council overseeing the research is barred from issuing requirements on insurance coverage. President Obama says the research goal is to provide information to doctors and patients about what treatments may work best for a medical condition. And Julius Hobson, a health policy adviser for the law firm Bryan Cave in Washington, says private insurers would be more likely than Medicare to use that treatment information to make rationing-style decisions.

CLAIM: If you like your health plan, you can keep your health plan; if you like your doctor, you can keep your doctor under reform.

THE FACTS: President Obama has used this line often to tamp down fears about change. But keeping a health plan or a doctor isn't a guarantee even under the current insurance system. Employers now switch insurance plans frequently to get the best possible deal. Doctors, if dissatisfied, can drop out of health plans. So it's difficult to see how reform could ensure that individuals can keep their health plan or doctor.

Obama's plan builds on the current job-based coverage system, and insurance provided by large employers may stay the same. But reform may mean some employers may choose to drop their current coverage and pay a penalty instead. The Congressional Budget Office (CBO) says millions would gain job-based coverage under the House Democrats' legislation, and that millions would lose it.

CLAIM: The House bill is entirely paid for by a combination of Medicare cuts and taxes, and won't add to the deficit.

THE FACTS: The CBO says the House bill would add $239 billion to the deficit over 10 years, with that extra money reversing a scheduled Medicare pay cut to doctors. Democrats don't count that increase as part of the cost of reform, saying it's a separate issue.

Obama has estimated that about $500 billion to $600 billion in Medicare and Medicaid savings can be achieved by restructuring the delivery system, establishing new ways of paying doctors, reducing waste, decreasing medical errors, increasing efficiency, and other changes.

Long-term savings from such ''game-changers'' could be substantial, but would accrue over a 20- to 30-year timetable, says Josh Gordon, policy director for the Concord Coalition, a grassroots organization advocating fiscal responsibility.

The reform bills aren't yet paid for fully, FactCheck.org concludes.

CLAIM: Health reform will cover illegal immigrants.

THE FACTS: Not true. Both the House legislation and the Senate health committee bill rule out subsidizing insurance coverage for anyone who is not a citizen or legal resident. Illegal immigrants get care now -- often in emergency rooms, with the cost frequently borne by hospitals, those who have private insurance coverage, and even taxpayers.

CLAIM: Reform will lead to socialized medicine, like the British system.

THE FACTS: Some Republicans and other opponents of the plan have repeated phrases such as 'government takeover of health care' to rouse opposition. But the Democratic legislation doesn't create a ''single-payer'' system in which government controls health care. The bills would preserve the private insurance system.

Reform would increase government regulation over health insurers. And an option for a public insurance plan, run like Medicare, would inject more federal funding into health care and could alter the market while competing with insurers in an exchange. A public plan would add to government's role, ''but it's not a takeover of health care,'' Hobson says. Recently the White House has backed off somewhat in its insistence on a public plan as part of reform.

CLAIM: Reform will raise your taxes.

THE FACTS: True for the richest Americans, under the House legislation. House leaders have proposed a surcharge or tax on the wealthiest individuals to help pay the cost of reform.

Obama has talked about limiting tax deductions for the wealthiest, and has insisted that the middle class not receive higher taxes. 'It's clear that some taxes will be raised to pay for reform,'' says Gordon. Other tax ideas include a levy on lush, Cadillac-style benefits plans.

CLAIM: Health care overhaul will contain health care costs.

THE FACTS: Health care costs for years have risen faster than inflation, and as a result, insurance premiums have more than doubled over the past decade. But while containing these costs is a goal of reform, many experts believe the current House legislation doesn't do enough. Gordon says greater cost control could be accomplished by capping the tax exclusion on employer health benefits, creating an independent commission to evaluate Medicare payments, and moving Medicare to a system that rewards quality of care, not quantity of services.

CLAIM: The U.S. has the best health care system in the world.

THE FACTS: Statistics suggest we're not getting enough bang for the buck. The U.S. spends 20% more per capita on health care than the next highest-spending country, and 50% more than the third. Countries in the Organization for Economic Co-operation and Development with the highest life expectancy spend half as much per capita as the U.S., notes FactCheck.org, which also cites a 2000 report from the World Health Organization that ranked the U.S. 37th in overall health system performance and 72nd on level of health. 'If you're concerned about primary care, you may be better off in another developed country,'' says Hobson.' If you need to see a specialist, you can't beat the U.S.''

CLAIM: Reform will cut benefits to people on Medicare.

THE FACTS: Obama calls this a myth, and he's right, according to AARP. None of the proposals would reduce seniors' benefits, the organization says. And Obama says reform will narrow the infamous 'doughnut hole' in Medicare prescription drug coverage. Health reform supporters do plan to eliminate subsidies to private insurance companies who offer Medicare Advantage coverage; the effects of the cuts on those plans are unknown.

CLAIM: Reform will lead to government subsidizing abortion.

THE FACTS: PolitiFact.com, a fact-checking web site, says the legislation contains nothing that would require the use of taxpayer money for subsidizing abortion. An amendment in House legislation aims to ensure that federal funds are not used for this coverage.

Obama noted recently that 'we also have a tradition of, in this town, historically, of not financing abortions as part of government-funded health care.'' PolitiFact also says people could have a choice of a health plan that has payment for abortion coverage, and one without it. It's possible that women with subsidized coverage could buy a plan that has abortion coverage. The final wording on this issue, though, won't be clear till later in the process.


SOURCES:

Politico; CNN; Medical News Today; PBS.org; The Wall Street Journal; AARP Bulletin; FactCheck.org; Dow Jones Newswires; The Los Angeles Times; Kaiser Family Foundation; The Washington Post; The Associated Press; PolitiFact.com; NPR; Julius Hobson, health policy adviser, Bryan Cave LLP; Josh Gordon, policy director, the Concord Coalition

Health Reform: A Government Takeover?

By Andy Miller
WebMD Guest Blogger

A Democratic president calls for a national health insurance program. Opponents denounce it as socialized medicine – too much government.

2009, meet 1945.

Long before Barack Obama was born, Harry Truman proposed a health care plan for the country. But the American Medical Association raised fears about government control of medicine and eventually helped sidetrack Truman's idea.

The players have changed, yet the playbook for health reform opponents looks remarkably the same. Often heard on television and talk radio these days are warnings of an impending invasion of the health care system. The buzzwords: Government intrusion. Government control. Government takeover.

Frequently mentioned concerns include government rationing of medical care and potential euthanasia of the elderly (a distortion of a provision in Democrats' plan, according to factcheck.org). Sarah Palin joined the fray, labeling Obama's plan "evil."

Obama addressed the takeover notion at a recent appearance in North Carolina: "Nobody is talking about some government takeover of health care. I'm tired of hearing that. I have been as clear as I can be.

"Under the reform I've proposed, if you like your doctor, you keep your doctor; if you like your health care plan, you keep your health care plan. These folks need to stop scaring everybody, you know?"

Yet opponents have turned up the heat. Last week, anti-reform demonstrators disrupted town hall meetings on health care.

"Anything to demonize health reform is something opponents have been doing for decades,'' says Ken Thorpe, an Emory University health policy expert. "Most people don't understand what's in the legislation. There's a lot of misinformation."

First, some basics about U.S. health care: Government already has a massive imprint in health care, with its programs such as Medicare and Medicaid accounting for almost half of U.S. health care spending.

And government-run Medicare is exceedingly popular among seniors. A recent survey by the Commonwealth Fund found that elderly Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than people covered by employer-sponsored plans.

"Medicare has always polled as highly popular among seniors,'' Thorpe says.

Many people don't realize that Medicare gives physicians more autonomy than private insurance and has launched innovations such as Hospice, says Donald Taylor, a Duke University health policy professor.

Still, reform advocates face a $2 trillion-a-year challenge: changing a system that is one-sixth of the U.S. economy. Obama and the Democrats have taken on a gigantic task. People don't like change -- and this change affects them personally, Taylor notes.

America will hear much more about reform and government during the August congressional recess. Already, more than $52 million has been spent this year on health care reform-related ads, according to the Campaign Media Analysis Group.

The government takeover talk, Taylor adds, "has been shockingly effective."

Critics have focused on one House reform provision, a "public plan." That's a government-run Medicare-like option that would compete with private insurers in a national marketplace, or exchange.

This public option could ruin private insurance, opponents charge. They cite a Lewin Group study that said under one scenario, more than 100 million Americans could end up on a public plan.

The Congressional Budget Office put the number at 10 million to 11 million.

Still, Robert Moffit, director of the Heritage Foundation's Center for Health Policy Studies, says a government takeover is not an exaggeration. The House bill, he says, will allow the federal government to determine an acceptable benefits plan, set up an insurance exchange, and run a public health plan. "I don't think there's any intention to preserve private insurance," Moffit says. "It's a huge concentration of power into the hands of federal officials."

Reform advocates, though, may abandon the public option in favor of nonprofit health insurance co-ops, run locally or regionally, which would compete with private insurers. The White House last week signaled that Obama may accept the co-op idea if consumers are guaranteed more choice and competition in buying insurance.

One way to reverse the momentum, Emory's Thorpe says, is for reform supporters to address the public's question: What's in it for me?

Obama will emphasize the insurance prohibitions in the legislation, which bars discrimination against people with medical conditions, as part of the upcoming outreach for middle class support, says Ron Pollack, executive director of consumer group Families USA.

Thorpe says reform also must contain real measures to contain health care costs, which have been rising for businesses and employees at rates higher than inflation, causing many to drop or sharply limit insurance coverage.

The Senate Finance Committee apparently is pushing toward a strong, independent commission to oversee Medicare spending. Taylor says it should work like the military base-closing panel, which curbs the influence of politics and lobbying in decision making.

Worrying about health costs is the one area of agreement for everyone, even foes of the Democrats' plan, Taylor notes. That's one advantage that Obama has over the Clinton's administration's stab at reform in the 1990s, he says.

Back then, various stakeholders defended the status quo. "Not many folks are saying that now," Taylor says.


SOURCES:

Ken Thorpe, Robert W. Woodruff Professor, Rollins School of Public Health,
Emory University; Donald Taylor, assistant professor of public policy, Duke University; Robert Moffit, Director, Center for Health Policy Studies, the Heritage Foundation; Ron Pollack, executive director, Families USA ; The Associated Press.; Cleveland.com: "Obama declares that health care reform isn't a government takeover."; The Truman Library; Geselbracht, R. The Civil Rights Legacy of Harry S. Truman, Truman State University Press, July 1, 2007; Kaiser Family Foundation; The Commonwealth Fund; The Wall Street Journal: "Ten Questions on the Health-Care Overhaul."; The Lewin Group; The Washington Post: "Groups Take Health-Reform Debate to Airwaves."; Factcheck.org.