Monday, April 6, 2009

Brain Researchers Open Door to Editing Memory

Suppose scientists could erase certain memories by tinkering with a single substance in the brain. Could make you forget a chronic fear, a traumatic loss, even a bad habit.

Researchers in Brooklyn have recently accomplished comparable feats, with a single dose of an experimental drug delivered to areas of the brain critical for holding specific types of memory, like emotional associations, spatial knowledge or motor skills.

The drug blocks the activity of a substance that the brain apparently needs to retain much of its learned information. And if enhanced, the substance could help ward off dementias and other memory problems.

So far, the research has been done only on animals. But scientists say this memory system is likely to work almost identically in people.

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NewYork-Presbyterian Offers Digital Records -

Online personal health records — controlled by patients themselves, not by hospitals, doctors, insurers or employers — have been available for years. Yet only a small percentage of Americans have digital personal health records today, analysts estimate.

A major obstacle to adoption has been getting useful medical and patient information into personal health records. Typing one's personal health information into an online form is time-consuming, mind-numbing and error-prone.

To overcome that challenge, Microsoft and Google have announced partnerships in recent months with large health care providers like Cleveland Clinic, Mayo Clinic and Kaiser Permanente to explore transferring patient data automatically into personal health records.

NewYork-Presbyterian Hospital, whose centers and clinics provide about 20 percent of the health care in New York, is the first large institution to move beyond the pilot stage this week as it begins to offer consumer-controlled health records for patients, and its experience will be closely watched in the industry.

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Sunday, April 5, 2009

Getting a Health Policy When You’re Already Sick -

INSURANCE executives held out hope to the afflicted late last month by announcing their willingness to end a notorious industry practice: charging higher premiums to people with health problems or denying them coverage altogether.

But don't breathe easy just yet. The change, promised at a Senate hearing, would hinge on the condition that Congress in turn require everyone in the land to carry health insurance. And Congress is still at least months away from taking up major health legislation.

So for now, consumers with pre-existing medical conditions must continue the struggle to obtain and keep medical coverage.

"It is arguably the biggest minefield out there when it comes to getting and keeping your health insurance," said Karen Pollitz, project director at the Health Policy Institute at Georgetown University. "Under the current system, the people who need insurance most can't afford or can't get coverage."

Until the system changes, here is basic guidance for people with pre-existing conditions, whether you're currently covered or shopping for insurance.

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Finding a Doctor Who Accepts Medicare Isn’t Easy -

EARLY this year, Barbara Plumb, a freelance editor and writer in New York who is on Medicare, received a disturbing letter. Her gynecologist informed her that she was opting out of Medicare. When Ms. Plumb asked her primary-care doctor to recommend another gynecologist who took Medicare, the doctor responded that she didn't know any — and that if Ms. Plumb found one she liked, could she call and tell her the name?

Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors' reasons: reimbursement rates are too low and paperwork too much of a hassle.

When shopping for a doctor, ask if he or she is enrolled with Medicare. If the answer is no, that doctor has opted out of the system. Those who are enrolled fall into two categories, participating and nonparticipating. The latter receive a lower reimbursement from Medicare, and the patient has to pick up more of the bill.

Doctors who have opted out of Medicare can charge whatever they want, but they cannot bill Medicare for reimbursement, nor may their patients. Medigap, or supplemental insurance, policies usually do not provide coverage when Medicare doesn't, so the entire bill is the patient's responsibility.

The solution to this problem is to find doctors who accept Medicare insurance — and to do it well before reaching age 65. But that is not always easy, especially if you are looking for an internist, a primary care doctor who deals with adults. Of the 93 internists affiliated with New York-Presbyterian Hospital, for example, only 37 accept Medicare, according to the hospital's Web site.

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