Hearing aid users urge Quebec to expand coverage
The province's health insurance board pays for two hearing aids for children, people with visual impairment and adults who are studying or working. But coverage drops to one hearing aid for people over 19 who aren't working or studying — mostly seniors. Some groups are calling for that to change.
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Yahoo
43 minutes ago
- Yahoo
Weight-loss jabs may need to be taken for life, experts warn
Weight-loss jabs may have to be used for many years if the long-term benefits to patients and the NHS are to be realised, experts have said. The drugs are sold under brand names like Mounjaro and Wegovy and work by reducing food cravings. Obese patients can currently be prescribed the jabs on the NHS after being referred to specialist weight loss clinics, which are usually located in hospitals. Hundreds of thousands of people also access the medication privately at pharmacies. There have been warnings about buying potentially unsafe jabs online from unregulated retailers and potentially missing out on wraparound support. Experts said the jabs should not be seen as the first option in weight loss and should be used in conjunction with lifestyle changes, such as eating more healthily and increasing exercise. Professor Graham Easton, a GP who has been using weight loss jabs himself, said: 'I think it's a major issue about the proper funding and resourcing of not only the GPs in the surgeries but also the wraparound care we talked about. 'I think the other issue is that so far, to my knowledge, the NHS and National Institute for Health and Care Excellence have talked about this being something you take for two years, and that's probably related to data from research studies. 'But as we discussed, this is likely to be a lifelong commitment if it is going to be worthwhile to the NHS. 'There's no point in most people taking it for a couple of years and then have the weight bouncing back. 'You can argue possibly you're about to prepare for surgery or something, but in most cases it doesn't make any sense. 'Then I think there's a big issue around access. Most obesity occurs in poorer populations as wealthier populations tend to not be so affected. 'There's a massive sort of socio-economic inequality and there is a worry about this driving that inequality even further. 'Unless the NHS makes sure that these are available across the board equally, I think that's a major risk.' Prof Easton said recent studies had shown people who stopped taking the drugs had put the weight they lost back on within around a year. 'That's often true of any diet, people would say, and that's certainly my experience of having wrestled with my weight in diets over the years,' he said. 'All I would say that I found interesting from that review was that they were suggesting perhaps that weight returns even quicker after having been on GLP-1 drugs. 'Then speculating, because there was no way of knowing from that review, that perhaps it's because people are not changing the behaviours we've been talking about like exercise and other lifestyle changes, just relying on the drugs. 'When you stop them, of course, you're going to put weight back on. The switch is turned back off, or whatever it was. 'I mean very similar to, for example, statins or anti-hypertensive blood pressure medications, if you want lifelong effects, you have to keep on them lifelong.' Prof Easton was speaking at an event at the Cheltenham Science Festival discussing the growing use of weight loss drugs with neurophysiologist Dr Simon Cork and consultant endocrinologist and obesity expert Dr Tony Goldstone. Dr Cork said the jabs have an important role to play in losing weight but are part of wider changes to diet and lifestyle. 'I think we have to understand that diet is always limited. People will tend to lose on average around 5% of their body weight on a diet,' he said. 'But you're hungry, you're miserable, you're tired, your wife hates you because you're so grumpy, you're not going to continue with that. 'But we should absolutely all be looking at our diet and all changing our diet, and doing something.' Dr Goldstone said weight loss drugs had been used in the treatment of diabetes for over a decade and had benefits of reducing the risk of developing other conditions. 'We're now in the third and fourth generation of these drugs, but the first generation of these drugs we've been using for 15 years for diabetes,' he said. 'There is nothing of concern that has emerged. In fact, all we're seeing are benefits. I'm not too worried about longer term side effects coming out. 'There is no real biological reason why there should be dangerous side-effects in the way that we know these drugs work. 'The benefits of the weight loss improvement in the diabetes are actually by themselves helping health and preventing other diseases, like cancer, heart attacks, renal failure, and potentially even reducing the risk of Alzheimer's disease. 'All those benefits, even if there was something that we hadn't really thought of that emerged down the line, I suspect that the harm of that is outweighed by the potential benefits of weight loss improvement in diabetes control.' Dr Cork said no drug is without side-effects and previous weight loss medications had failed because of them. 'There are side-effects, there are some concerning side-effects that tend to be very rare, but then you can monitor for those side-effects,' he said. 'As long as you're getting the correct care, as long as your GP is aware that you're taking them, then those should be identified. 'If you do find those side-effects, you can stop taking the drug.'
New York Times
43 minutes ago
- New York Times
We Saw Medicaid Work Requirements Up Close. You Don't Want This Chaos.
Many of the Republicans pushing for Medicaid work requirements — permanent program cuts that will strip up to 14 million people of their health care coverage — likely have no idea what it takes to comply with them. We do. As legal aid lawyers, we were on the front lines helping low-income people in Arkansas keep their health care coverage when the state rolled out work requirements in 2018. The policy caused chaos for everyone involved: people receiving Medicaid, hospitals and health clinics, pharmacies, social services organizations and state agency caseworkers. No officials serious about governing should willingly create such problems for their own state. Over 18,160 people in Arkansas lost coverage in only five months before courts halted the policy. Many were our clients. Adrian McGonigal had chronic obstructive pulmonary disorder, for which he received treatment. At the time he held a job working 30 to 40 hours a week at a poultry plant, which paid more than any other job he'd had before and should have satisfied the requirement. But the state's system for automatically identifying working people was faulty, and Mr. McGonigal struggled to navigate the complex monthly reporting system on his own. Unable to report his work, he lost Medicaid, couldn't afford his C.O.P.D. medications, wound up in the hospital emergency room several times, lost his job and never fully recovered. For the next several years he struggled in various minimum-wage jobs, earning much less than he had at the poultry plant. Sadly, he died in November. We saw many working people face similar challenges. Our clients ran the gamut of low-wage work: fast food workers, restaurant dishwashers and servers, construction workers, janitors, landscapers, motel cleaners, gas station clerks and nursing assistants. Many had disabilities, and their ability to continue working depended on getting treatment to manage chronic pain, asthma, injuries, cancer and mental health conditions. Some lost coverage simply because they couldn't navigate the policy's complicated requirements and labyrinthine reporting process. Others lost insurance because of the instability of low-wage work: Bosses cut their hours or laid them off without warning, limited public transit narrowed their options or they lived in struggling rural areas where jobs were hard to come by. When the state cut them off, their health worsened and many lost jobs, as well as the ability to work new ones. Nobody on Medicaid was free from the tumult. Despite outreach from the state, there was widespread panic, as people didn't know if they had the type of Medicaid that the new requirements applied to. People received confusing 10-page letters from the state Medicaid office, which often contradicted other coverage letters people received around the same time. The website to report compliance shut down every night at 9 p.m., and when it was running, it was so complex that we put together video tutorials to help people navigate it successfully. (Many still couldn't.) People spent hours on the phone or at agency offices trying to figure out their status or fix errors, often needing a lawyer's help. In some cases, they had to pester their employers for extra proof of wages or statements that met the state's requirements. All told, 18,164 people were terminated because of noncompliance with the work requirements, and thousands more people lost coverage because of related paperwork burdens. What's more, these penalties operated as a tax on key economic sectors. Hospitals and health clinics, many already barely surviving in rural areas, assumed additional costs to untangle billing nightmares, absorb more uncompensated care and help confused patients document their eligibility for coverage. Local nonprofits, including services for the homeless, domestic violence shelters, food banks, soup kitchens and senior centers, spent their scarce resources trying to help people comply. Pharmacists dealt with the desperation of people learning for the first time that they had lost coverage and would have to pay out of pocket for their prescriptions. The state Medicaid agency also bent under the weight. Agency management sloughed off the thankless and time-consuming tasks of cleaning up endless system errors, figuring out workarounds and calming frantic people to overburdened caseworkers. At one point, the state's call centers were so overwhelmed that the agency expanded its hours of operation, which still didn't prevent lengthy wait times. Want all of The Times? Subscribe.
Yahoo
an hour ago
- Yahoo
'Troubling decline' in secondary school PE lessons
A "troubling decline" in the number of hours England's secondary school pupils spend doing physical education (PE) "should be a wake-up call to society", according to children's exercise charity the Youth Sport Trust (YST). The organisation says figures show "nearly 4,000 PE hours lost in the last year alone" in state-funded schools, and calls for "urgent action to protect and prioritise" the subject. The YST also claims that since the London 2012 Olympics "almost 45,000 PE hours have disappeared from secondary school timetables", and that the number of PE teachers in England has also dropped by 7%. In response, the government said it is "determined to break down barriers to accessing PE and school sports for young people". In its annual report, the YST says that 2.2 million children in England are now doing less than 30 minutes of activity a day, and less than half (48%) are meeting the UK's Chief Medical Officers' recommendation of at least 60 minutes of physical activity a day. It says the steepest decline has hit 11-14-year-olds, with more than 2,800 hours cut and 347 teachers lost for this age group in the past year, at a time of rising childhood obesity rates. YST also adds that girls, children with special educational needs and disabilities (SEND), and those from disadvantaged backgrounds "continue to face the greatest barriers to being active". However, the study also found that 93% of young people believe PE is important, 71% want to be more active at school, and 96% of teachers agree that sport and play benefit mental wellbeing. While PE is a mandatory subject in schools, the recommended amount of two hours a week is not enforced. YST chief executive Ali Oliver said: "Our children are moving less, feeling unhappier, and losing access to the transformative power of PE, contributing to stagnant physical activity levels. "The fall in PE hours is sadly an exacerbation of a longer-term trend and should be a wake-up call to society, from policymakers to schools and parents. "Unless we take action to reverse these damaging trends and increase activity levels to improve wellbeing, we risk failing a generation." In a statement, the government said: "These figures highlight the government's dire inheritance, but we're determined to break down barriers to accessing PE and school sports for young people through our Plan for Change, helping to improve their mental and physical wellbeing. "We are working across the government and with our partners including Youth Sport Trust and Sport England to boost participation and have already invested £100m to upgrade sports facilities and launched a programme to improve access to sports for pupils with special education needs and disabilities. "Our ongoing curriculum and assessment review seeks to deliver a broader curriculum, so that children do not miss out on subjects including PE and sport."
