Latest news with #allergy
The Guardian
a day ago
- General
- The Guardian
I was terrified of bees – until the day 30,000 of them moved into my house
As a child, I was allergic to bees. Just one sting on my fingertip could swell my whole arm. I was allergic to most things – dust, cat hair, pollen – and was always clutching an inhaler, sniffling into my sleeve and keeping a safe distance from stinging insects. As an adult, when my family bought our first house, a mid-century gem nestled in thick bushland on Sydney's Northern Beaches, I wasn't expecting a visit from my former nemesis. But one warm spring day, we heard the unmistakable hum of 20,000 of those honey-producing insects. 'Bees!' I shouted, as a large dark ball headed straight towards me and my baby girl. Terrified, I grabbed her and slammed the patio doors just in time. The swarm broke apart in the air and the buzzing became thunderous. I later learned that bees swarm when their current hive becomes overcrowded. Once the swarming instinct is triggered, scouts head out to find a new location and the old queen and her worker bees fly off to their new, less cramped abode. The bees left behind will then raise a new queen. During renovations we discovered masses of old honeycomb and dead bees in the ceilings and walls of our home; the swarm was likely attracted to that scent. As tens of thousands of bees squeezed into the wall cavity of our living room, my first instinct was to call a beekeeper. Bees are a precious creature – vital for pollination, food security and a healthy ecosystem. Unfortunately, the beekeeper couldn't help. 'Once the bees are in a wall, they're very difficult to extract,' he said, before hanging up. I called another and another, until eventually I resorted to pest control. We sealed the entry points along the wall and hoped another swarm wouldn't find its way to us. Sign up for the fun stuff with our rundown of must-reads, pop culture and tips for the weekend, every Saturday morning Years later, one did. We had just returned home from a stint in Singapore when I heard the familiar buzz of bees announcing their arrival. This swarm was big – 30,000 strong – and they quickly pushed their way into the walls and our stairwell cavity. I tried again to find a beekeeper to guide us, desperately searching the internet for local beekeeping associations; I couldn't stomach calling pest control again. This time, we found the right person – a young beekeeper who arrived on our doorstep an hour later with his gear and beekeeper suit. First, he set up a lure outside – a bait hive, filled with old comb and a few drops of lemongrass oil, which mimics a bee pheromone and can entice a swarm to move. He put up a ladder and placed the wooden box near the entry point to the wall, hoping the queen and her workers would leave our property and set themselves up in the bait hive. Over the next week, we waited and watched and hoped. Unfortunately, the bees did not budge. Sign up to Saved for Later Catch up on the fun stuff with Guardian Australia's culture and lifestyle rundown of pop culture, trends and tips after newsletter promotion Plan B (bee?) was to entice the swarm from closer range. By now, the bees were already building comb and storing honey in a small cavity above the stairs, preparing to rear eggs and larvae. The beekeeper convinced us to let him cut a hole in our floor; he then placed the box directly on top of the hive – right in the middle of our living space. We got on with our daily lives, cooking, watching TV, working … all the while cohabiting alongside thousands of bees. Occasionally, one would pop out of our air conditioning unit or get confused on its pollen route and fly through an open window. But for the most part, they were excellent housemates. Living with the constant low hum of bees and learning more about their behaviour and habits from the beekeeper, my fear and anxiety began to dissipate. I stopped using insect spray and instead, transported the lost bees back outside on a piece of paper. I wasn't once stung – they seemed to sense I wasn't going to harm them. Weeks later, we were finally ready to move the bees to greener pastures – a farm where the beekeeper already kept established hives. He confessed it was the most difficult hive removal he'd ever done. It took several 20-litre buckets full of honey and comb, a lot of smoke to calm the bees down, and some escapees, but he managed to save two-thirds of the hive. Once the bees were gone, the house felt too quiet. Wax moths came to clean up the leftover beeswax and pollen. Spiders came to eat the wax moth and larvae. We repaired the floor. Every spring, when the air starts to lose its chill and pollen makes me sneeze, I keep watch for scout bees and make a very important phone call. The beekeeper answers: he'll be round with a bait hive to lure the bees away from our walls, should they come to visit. So far, so good. Pip Harry is an author. Her latest young adult novel, Drift, inspired by her experience with the bees, is out in Australia on 30 July (Hachette Australia, $17.99)
Daily Mail
a day ago
- Health
- Daily Mail
FDA issues urgent recall of ice pops sold nationwide over undeclared deadly allergen
The FDA is warning Americans of ice pops that could cause a 'life-threatening allergic reaction.' Tropicale Foods of Ontario, California, is recalling a variety of its Helados Mexico and La Michoacana ice pops from stores across the country because they may contain undeclared milk. People who have a milk allergy may be at risk of a severe reaction if they eat the product. The ice pops were sold nationwide at stores including Walmart, Dollar Tree and Safeway. The recall was initiated after a variety of products were found to contain milk but were distributed in packaging that did not reveal the presence of the ingredient. An investigation found that though the products included 'cream' in the ingredient lists, the common name 'milk' was not declared. Approximately 6.2 million Americans have a milk allergy, making it one of the most common food allergies. The discovery was made after the company conducted an audit of all its product labels. One consumer illness has been reported to date in connection to the recall, according to the FDA, but no details were revealed. Some of the affected flavors include coconut, strawberry, bubble gum, cookies and cream and mango. These were sold as single ice pops and also in variety packs. The best buy dates range from May 29, 2026 to July 14, 2027. Customers who bought the product and are allergic or sensitive to milk are urged to discard it or return it to the place of purchase. Milk can cause severe reactions in the 30 to 50million Americans with lactose intolerance and the 7million with dairy allergies. People who are lactose intolerant cannot properly digest lactose, a sugar found in milk and other dairy products. This occurs because their bodies don't produce enough of the enzyme lactase, which is needed to break down lactose. Undigested lactose then travels to the gut and gets fermented by bacteria, leading to digestive distress. Symptoms usually start within 30 minutes to two hours of consuming a dairy product and include diarrhea, nausea, vomiting, stomach cramps, bloating and gas. Additionally, roughly two percent of Americans - 6.6million - are allergic to milk. Symptoms of an allergy include hives, wheezing, coughing, congestion, face and throat swelling and in severe cases, anaphylaxis. This is a life-threatening allergic reaction that occurs very quickly after being exposed to an allergen. It triggers an extreme immune response, leading to dizziness, fainting, shortness of breath and vomiting. If not treated quickly with epinephrine (adrenaline), which can be administered via injection like an EpiPen or nasal spray, a person can die.
Yahoo
a day ago
- Business
- Yahoo
Thermo Fisher Scientific Showcases Diagnostics Solutions Designed to Meet Evolving Global Healthcare Demands at ADLM 2025
Comprehensive portfolio—from women's health to allergy, autoimmune and oncology testing—advances laboratory processes through the ability to provide earlier and more efficient detection and diagnosis CHICAGO, July 28, 2025--(BUSINESS WIRE)--Thermo Fisher Scientific, the world leader in serving science, showcases its innovations in improving clinical and diagnostic laboratory efficiency and workflow optimization during the Association for Diagnostics & Laboratory Medicine Conference (ADLM), July 27-31, 2025, in Chicago, Ill. The company debuts two new solutions, LabLink360™* and Thermo Scientific™ MAS™ Max quality controls, designed to support quality control assurance and streamline workflows in clinical laboratories. It also features its rapid next-generation sequencing (NGS) technology, recently approved by the U.S. Food and Drug Administration (FDA), the Oncomine™ Dx Express Test on the Ion Torrent™ Genexus™ Dx Integrated Sequencer, for use as a companion diagnostic for Dizal's ZEGFROVY® (sunvozertinib) and for tumor profiling applications. "Our solutions harness our scientific expertise to enhance care by enabling earlier and more precise detection and diagnosis. In partnership with our customers, we're working every day to bring better, faster and safer diagnostics to all patients," said Puneet Sarin, senior vice president and president, specialty diagnostics at Thermo Fisher. "At Thermo Fisher, we are committed to advancing diagnostics that address today's most pressing global health challenges by boosting efficiency and reducing overall laboratory costs — ultimately driving more optimal patient care." Harnessing Innovation for Quality Assurance, Efficiency and Sustainability in the Clinical Lab Clinical laboratories rely on quality assurance programs (QAPs) to ensure test result accuracy, which is essential for proper diagnosis and treatment. In resource-limited settings, a QAP that delivers quick, actionable insights can ease operational bottlenecks, improve workflow efficiency and enhance data-driven decisions. Thermo Fisher's new LabLink360 is a next-generation QAP software designed to help enhance patient safety, reduce errors and elevate healthcare quality. It features Sigma-metric analysis, a global benchmarking tool that helps labs assess performance and optimize quality control parameters based on results. Thermo Fisher also recently launched the Thermo Scientific MAS Omni•CORE™ Max load-and-go quality controls (QC) to help simplify and automate lab workflows, allowing lab technicians to be more efficient and focus more on delivering fast and accurate patient results. The Omni•CORE Max QCs are part of a portfolio of QCs for clinical diagnostic testing, including the MAS Diabetes Max, which can help labs reduce daily QC bottles by up to 54% and lot-to-lot validations by up to 77%.** Beyond supporting the improved efficiency of laboratories, Thermo Fisher is also committed to supporting customers' sustainability initiatives. While most labs print patient results, QC, calibrations and other instrument data and place them in storage, this practice contributes to a staggering environmental impact. The company will present a poster and a micro-lecture explaining the transformative benefits of transitioning to a paperless laboratory environment. Targeting Unmet Diagnostic Needs Approximately 85% of patients in the U.S. receive cancer care in community settings. However, these sites have historically lacked consistent access to rapid and reliable next-generation sequencing, which is playing a growing role in informing precision oncology treatment decisions. At ADLM, the company will present its rapid NGS solution, the Oncomine Dx Express Test on the Ion Torrent Genexus Integrated Sequencer. Available as both an RUO solution and for clinical use on the Genexus Dx System, more care teams can now access NGS results in as little as 24 hours*** to help make more informed treatment recommendations for their patients, while also sparing patients from unnecessary delays, procedures and uncertainty. Also helping expand vital testing the company will highlight its PreClara™ Ratio,**** cleared in 2023 and previously known as B·R·A·H·M·S™ sFlt-1/PlGF KRYPTOR™ Test System, which offers clarity in assessing the risk of developing preeclampsia with severe features in hospitalized pregnant women within two weeks of testing. As the first FDA-cleared biomarker test for preeclampsia risk assessment, the PreClara Ratio provides reliable, quantifiable results with excellent analytical and clinical performance. When combined with other laboratory tests and standard clinical assessment, the PreClara Ratio may enable more informed clinical decisions, with the aim of improving health outcomes for both mothers and their babies. Thermo Fisher will also highlight its EXENT® Solution, a fully integrated and automated mass spectrometry system designed to transform diagnosis and assessment for patients with monoclonal gammopathies, including multiple myeloma. The EXENT Solution enables more sensitive analytical methods that can differentiate between patient subsets without requiring invasive bone marrow biopsy techniques too early. It is currently available for clinical use in Brazil, Belgium, France, Germany, Italy, the Netherlands, New Zealand, Spain, the United Kingdom, Switzerland and Australia. Thermo Fisher is also presenting its latest solutions for allergy and autoimmune diagnostics, oncology, women's health and quality control testing. In the booth, attendees can engage with a series of dynamic micro-lectures designed to advance industry knowledge and clinical expertise. These sessions cover a wide range of diagnostic topics and innovations, offering valuable insights into improving testing efficiency, patient outcomes and disease detection strategies. For more information on Thermo Fisher's activities at ADLM, please visit or conference booth (2812) to experience the full breadth of Thermo Fisher's diagnostic solutions. * Not yet commercially available.**Will vary for each laboratory depending on the configuration. Data on file.***Timing varies by number of samples and type of run.****Brand trademarked in the U.S. only. About Thermo Fisher Scientific Thermo Fisher Scientific Inc. is the world leader in serving science, with annual revenue over $40 billion. Our Mission is to enable our customers to make the world healthier, cleaner and safer. Whether our customers are accelerating life sciences research, solving complex analytical challenges, increasing productivity in their laboratories, improving patient health through diagnostics or the development and manufacture of life-changing therapies, we are here to support them. Our global team delivers an unrivaled combination of innovative technologies, purchasing convenience and pharmaceutical services through our industry-leading brands, including Thermo Scientific, Applied Biosystems, Invitrogen, Fisher Scientific, Unity Lab Services, Patheon and PPD. For more information, please visit View source version on Contacts Media Contact Information:Jessika Parry, Greenough419-266-4016jparry@ Errore nel recupero dei dati Effettua l'accesso per consultare il tuo portafoglio Errore nel recupero dei dati Errore nel recupero dei dati Errore nel recupero dei dati Errore nel recupero dei dati
The Guardian
4 days ago
- Health
- The Guardian
‘We need some hope': can a rural hospital on the brink survive Trump's bill?
When her severely allergic toddler, Josie, began gasping for breath in the middle of the night, Krissy Cunningham knew there was only one place she could get to in time to save her daughter's life. For 74 years, Pemiscot Memorial hospital has been the destination for those who encounter catastrophe in Missouri's poorest county, a rural stretch of farms and towns in its south-eastern Bootheel region. Three stories of brown brick just off Interstate 55 in the town of Hayti, the 115-bed hospital has kept its doors open even after the county's only Walmart closed, the ranks of boarded-up gas stations along the freeway exit grew, and the population of the surrounding towns dwindled, thanks in no small part to the destruction done by tornadoes. For many in Pemiscot county, its emergency room is the closest available without taking a 30-minute drive across the Mississippi river to Tennessee or the state line to Arkansas, a range that can make the difference between life and death for victims of shootings, overdoses or accidents on the road. In the wee hours of one spring morning, it was there that Josie received the breathing treatments and a racemic epinephrine shot that made her wheezing subside. 'There is no way I would have made it to one of the farther hospitals, if it wouldn't have been here. Her airway just would have closed off, and I probably would have been doing CPR on my daughter on the side of the road,' recalled Cunningham, a nurse who sits on the hospital's board. Yet its days of serving its community may be numbered. In May, the hospital's administration went public with the news that after years of struggling with high rates of uninsured patients and low reimbursement rates from insurers, they may have to close. And even if they do manage to navigate out of their current crisis, Pemiscot Memorial's leaders see a new danger on the horizon: the 'big, beautiful bill' Republicans pushed through Congress earlier this month, at Donald Trump's request. Centered around an array of tax cuts as well as funds for the president's mass deportation plans, the bill will mandate the largest funding reduction in history to Medicaid, the federal healthcare program supporting low-income and disabled Americans. That is expected to have ripple effects nationwide, but will hit particularly hard in Pemiscot county and other rural areas, where hospitals tend to have frail margins and disproportionately rely on Medicaid to stay afloat. 'If Medicaid drops, are we going to be even collecting what we're collecting now?' asked Jonna Green, the chairwoman of Pemiscot Memorial's board, who estimated 80% of their revenue comes from Medicaid as well as Medicare, another federal health program primarily for people 65 and older. 'We need some hope.' The changes to Medicaid will phase in beginning in late 2026, and require enrollees to work, volunteer or attend school 80 hours a month, with some exceptions. States are also to face new caps on provider taxes, which they use to fund their Medicaid programs. All told, the non-partisan Congressional Budget Office forecasts that 10 million people nationwide will lose their healthcare due to the bill, which is nonetheless expected to add $3.4tn to the federal budget deficit through 2034. Trump carried Missouri, a midwestern state that has veered sharply away from the Democratic party over the past three decades, with more than 58% of the vote last November. In Pemiscot county, where census data shows more than a quarter of residents are below the poverty line and the median income is just over $40,000 a year, he was the choice of 74% of voters, and Republican lawmakers representing the county played a notable role in steering his tax and spending bill through Congress. Senator Josh Hawley publicly advocated against slashing the healthcare program, writing in the New York Times: 'If Republicans want to be a working-class party – if we want to be a majority party – we must ignore calls to cut Medicaid and start delivering on America's promise for America's working people.' He ultimately supported the bill after a $50bn fund to help rural hospitals was included, but weeks later introduced legislation that would repeal some of the very same cuts he had just voted for. 'I want to see Medicaid reductions stopped and rural hospitals fully funded permanently,' the senator said. Jason Smith, whose district encompasses Pemiscot county and the rest of south-eastern Missouri, oversaw the crafting of the measure's tax provision as chairman of the House ways and means committee, and has argued they will bring prosperity rural areas across the state. Like others in the GOP, he has said the Medicaid cuts will ferret out 'waste, fraud and abuse', and make the program more efficient. It's a gamble for a state that has seen nine rural hospitals close since 2015, including one in a county adjacent to Pemiscot, with a further 10 at immediate risk of going under, according to data from the Center for Healthcare Quality and Payment Reform policy group. The Missouri Budget Project thinktank estimates that the bill will cost 170,000 of the state's residents their health coverage, largely due to work requirements that will act as difficult-to-satisfy red tape for Medicaid enrollees, while the cap on provider taxes will sap $1.9bn from the state's Medicaid program. 'There's going to be some really hard conversations over the course of the next five years, and I think that healthcare in our region will look a lot different than what it does right now,' said Karen White, CEO of Missouri Highlands Health Care, which operates federally qualified health centers providing primary and dental care across rural south-eastern Missouri. She forecasts 20% of her patients will lose Medicaid coverage through 2030. As the bill was making its way through Congress, she contacted the offices of Smith, Hawley and Missouri's junior senator, Eric Schmitt, all politicians she had voted for, asking them to reconsider cutting Medicaid. She did not hear back. 'I love democracy. I love the fact that we as citizens can make our voices heard. And they voted the way that they felt they needed to vote. Maybe … the larger constituency reached out to them with a viewpoint that was different than mine, but I made my viewpoint heard,' White said. Spokespeople for Schmitt and Smith did not respond to requests for comment. In response to emailed questions, a spokeswoman for Hawley referred to his introduction of the legislation to partially stop the Medicaid cuts. Down the road from the hospital lies Hayti Heights, where there are no businesses and deep puddles form in the potholes and ditches that line roadways after every thunderstorm. Mayor Catrina Robinson has a plan to turn things around for her 500 or so residents, which involves bringing back into service the water treatment plant that is the town's main source of revenue. But that is unlikely to change much without Pemiscot Memorial. 'Half of those people that work at the hospital, they're my residents. So how they gonna pay their bills? How they gonna pay their water bill, how they gonna pay their light bill, how they gonna pay rent? This is their source of income. Then what will they do?' Robinson said. Trump's bill does include an array of relief aimed at the working-class voters who broke for him in the last election, including tax cuts on tips and overtime pay and deductions aimed at senior citizens. It remains to be seen if whatever financial benefits those provisions bring to the workers of Pemiscot county will outweigh the impact of the stress the Medicaid cuts place on its healthcare system. 'The tax relief of server's tips and all that, that's not going to change the poverty level of our area,' said Loren Clifton, the hospital's administrative director. 'People losing their healthcare insurance absolutely will make it worse.' Work can be found in the county's corn, wheat, soybean and rice fields, at a casino in the county seat Caruthersville and at a shipyard along the banks of the Mississippi . But Green questions if those industries would stick around if the hospital goes under, and takes with it the emergency room that often serves to stabilize critical patients before transferring them elsewhere. 'Our community cannot go without a hospital. Healthcare, employment, industry – it would devastate everything,' Green said. The board is exploring partnerships with other companies to help keep the hospital afloat, and has applied for a federal rural emergency hospital designation which they believe will improve their reimbursements and chances of winning grants, though that will require them to give up other services that bring in revenue. For many of its leaders, the stakes of keeping the hospital open are personal. 'This is our home, born and raised, and you would never want to leave it. But I have a nine-year-old with cardiac problems. I would not feel safe living here without a hospital that I could take her to know if something happened,' said Brittany Osborne, Pemiscot Memorial's interim CEO. One muggy Wednesday morning in July, Pemiscot's three county commissioners, all Republicans, gathered in a small conference room in Caruthersville's courthouse and spoke of their resolve to keep the hospital open. 'It's 50-50 right now,' commissioner Mark Cartee said of the hospital's chances of survival. 'But, as long as we have some money in the bank of the county, we're going to keep it open. We need healthcare. We got to have a hospital.' They were comparatively sanguine about the possibility that the Medicaid work requirements would harm the facility's finances down the line. 'We got a guy around here, I guess he's still around. He's legally blind but he goes deer hunting every year,' commissioner Baughn Merideth said. 'There's just so much fraud … it sounds like we're right in the middle of it.' A few blocks away, Jim Brands, owner of Hayden Pharmacy, the oldest in the county, had little doubt that there were those in the county who took advantage of Medicaid. He also believed that fewer enrollees in the program would mean less business for his pharmacy, and more hardship overall. 'Just seeing this community, the situation it's in, the poverty, we've got to get people to work. There are a ton of able-bodied people that could work that choose not to,' he said. 'To me, there's got to be a better way to weed out the fraud and not step on the toes of the people who need it.'
The Guardian
4 days ago
- Health
- The Guardian
‘We need some hope': can a rural hospital on the brink survive Trump's bill?
When her severely allergic toddler, Josie, began gasping for breath in the middle of the night, Krissy Cunningham knew there was only one place she could get to in time to save her daughter's life. For 74 years, Pemiscot Memorial hospital has been the destination for those who encounter catastrophe in Missouri's poorest county, a rural stretch of farms and towns in its south-eastern Bootheel region. Three stories of brown brick just off Interstate 55 in the town of Hayti, the 115-bed hospital has kept its doors open even after the county's only Walmart closed, the ranks of boarded-up gas stations along the freeway exit grew, and the population of the surrounding towns dwindled, thanks in no small part to the destruction done by tornadoes. For many in Pemiscot county, its emergency room is the closest available without taking a 30-minute drive across the Mississippi river to Tennessee or the state line to Arkansas, a range that can make the difference between life and death for victims of shootings, overdoses or accidents on the road. In the wee hours of one spring morning, it was there that Josie received the breathing treatments and a racemic epinephrine shot that made her wheezing subside. 'There is no way I would have made it to one of the farther hospitals, if it wouldn't have been here. Her airway just would have closed off, and I probably would have been doing CPR on my daughter on the side of the road,' recalled Cunningham, a nurse who sits on the hospital's board. Yet its days of serving its community may be numbered. In May, the hospital's administration went public with the news that after years of struggling with high rates of uninsured patients and low reimbursement rates from insurers, they may have to close. And even if they do manage to navigate out of their current crisis, Pemiscot Memorial's leaders see a new danger on the horizon: the 'big, beautiful bill' Republicans pushed through Congress earlier this month, at Donald Trump's request. Centered around an array of tax cuts as well as funds for the president's mass deportation plans, the bill will mandate the largest funding reduction in history to Medicaid, the federal healthcare program supporting low-income and disabled Americans. That is expected to have ripple effects nationwide, but will hit particularly hard in Pemiscot county and other rural areas, where hospitals tend to have frail margins and disproportionately rely on Medicaid to stay afloat. 'If Medicaid drops, are we going to be even collecting what we're collecting now?' asked Jonna Green, the chairwoman of Pemiscot Memorial's board, who estimated 80% of their revenue comes from Medicaid as well as Medicare, another federal health program primarily for people 65 and older. 'We need some hope.' The changes to Medicaid will phase in beginning in late 2026, and require enrollees to work, volunteer or attend school 80 hours a month, with some exceptions. States are also to face new caps on provider taxes, which they use to fund their Medicaid programs. All told, the non-partisan Congressional Budget Office forecasts that 10 million people nationwide will lose their healthcare due to the bill, which is nonetheless expected to add $3.4tn to the federal budget deficit through 2034. Trump carried Missouri, a midwestern state that has veered sharply away from the Democratic party over the past three decades, with more than 58% of the vote last November. In Pemiscot county, where census data shows more than a quarter of residents are below the poverty line and the median income is just over $40,000 a year, he was the choice of 74% of voters, and Republican lawmakers representing the county played a notable role in steering his tax and spending bill through Congress. Senator Josh Hawley publicly advocated against slashing the healthcare program, writing in the New York Times: 'If Republicans want to be a working-class party – if we want to be a majority party – we must ignore calls to cut Medicaid and start delivering on America's promise for America's working people.' He ultimately supported the bill after a $50bn fund to help rural hospitals was included, but weeks later introduced legislation that would repeal some of the very same cuts he had just voted for. 'I want to see Medicaid reductions stopped and rural hospitals fully funded permanently,' the senator said. Jason Smith, whose district encompasses Pemiscot county and the rest of south-eastern Missouri, oversaw the crafting of the measure's tax provision as chairman of the House ways and means committee, and has argued they will bring prosperity rural areas across the state. Like others in the GOP, he has said the Medicaid cuts will ferret out 'waste, fraud and abuse', and make the program more efficient. It's a gamble for a state that has seen nine rural hospitals close since 2015, including one in a county adjacent to Pemiscot, with a further 10 at immediate risk of going under, according to data from the Center for Healthcare Quality and Payment Reform policy group. The Missouri Budget Project thinktank estimates that the bill will cost 170,000 of the state's residents their health coverage, largely due to work requirements that will act as difficult-to-satisfy red tape for Medicaid enrollees, while the cap on provider taxes will sap $1.9bn from the state's Medicaid program. 'There's going to be some really hard conversations over the course of the next five years, and I think that healthcare in our region will look a lot different than what it does right now,' said Karen White, CEO of Missouri Highlands Health Care, which operates federally qualified health centers providing primary and dental care across rural south-eastern Missouri. She forecasts 20% of her patients will lose Medicaid coverage through 2030. As the bill was making its way through Congress, she contacted the offices of Smith, Hawley and Missouri's junior senator, Eric Schmitt, all politicians she had voted for, asking them to reconsider cutting Medicaid. She did not hear back. 'I love democracy. I love the fact that we as citizens can make our voices heard. And they voted the way that they felt they needed to vote. Maybe … the larger constituency reached out to them with a viewpoint that was different than mine, but I made my viewpoint heard,' White said. Spokespeople for Schmitt and Smith did not respond to requests for comment. In response to emailed questions, a spokeswoman for Hawley referred to his introduction of the legislation to partially stop the Medicaid cuts. Down the road from the hospital lies Hayti Heights, where there are no businesses and deep puddles form in the potholes and ditches that line roadways after every thunderstorm. Mayor Catrina Robinson has a plan to turn things around for her 500 or so residents, which involves bringing back into service the water treatment plant that is the town's main source of revenue. But that is unlikely to change much without Pemiscot Memorial. 'Half of those people that work at the hospital, they're my residents. So how they gonna pay their bills? How they gonna pay their water bill, how they gonna pay their light bill, how they gonna pay rent? This is their source of income. Then what will they do?' Robinson said. Trump's bill does include an array of relief aimed at the working-class voters who broke for him in the last election, including tax cuts on tips and overtime pay and deductions aimed at senior citizens. It remains to be seen if whatever financial benefits those provisions bring to the workers of Pemiscot county will outweigh the impact of the stress the Medicaid cuts place on its healthcare system. 'The tax relief of server's tips and all that, that's not going to change the poverty level of our area,' said Loren Clifton, the hospital's administrative director. 'People losing their healthcare insurance absolutely will make it worse.' Work can be found in the county's corn, wheat, soybean and rice fields, at a casino in the county seat Caruthersville and at a shipyard along the banks of the Mississippi . But Green questions if those industries would stick around if the hospital goes under, and takes with it the emergency room that often serves to stabilize critical patients before transferring them elsewhere. 'Our community cannot go without a hospital. Healthcare, employment, industry – it would devastate everything,' Green said. The board is exploring partnerships with other companies to help keep the hospital afloat, and has applied for a federal rural emergency hospital designation which they believe will improve their reimbursements and chances of winning grants, though that will require them to give up other services that bring in revenue. For many of its leaders, the stakes of keeping the hospital open are personal. 'This is our home, born and raised, and you would never want to leave it. But I have a nine-year-old with cardiac problems. I would not feel safe living here without a hospital that I could take her to know if something happened,' said Brittany Osborne, Pemiscot Memorial's interim CEO. One muggy Wednesday morning in July, Pemiscot's three county commissioners, all Republicans, gathered in a small conference room in Caruthersville's courthouse and spoke of their resolve to keep the hospital open. 'It's 50-50 right now,' commissioner Mark Cartee said of the hospital's chances of survival. 'But, as long as we have some money in the bank of the county, we're going to keep it open. We need healthcare. We got to have a hospital.' They were comparatively sanguine about the possibility that the Medicaid work requirements would harm the facility's finances down the line. 'We got a guy around here, I guess he's still around. He's legally blind but he goes deer hunting every year,' commissioner Baughn Merideth said. 'There's just so much fraud … it sounds like we're right in the middle of it.' A few blocks away, Jim Brands, owner of Hayden Pharmacy, the oldest in the county, had little doubt that there were those in the county who took advantage of Medicaid. He also believed that fewer enrollees in the program would mean less business for his pharmacy, and more hardship overall. 'Just seeing this community, the situation it's in, the poverty, we've got to get people to work. There are a ton of able-bodied people that could work that choose not to,' he said. 'To me, there's got to be a better way to weed out the fraud and not step on the toes of the people who need it.'
