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Jeffrey V. Ravetch receives 2017 Ross Prize in Molecular Medicine – The Rockefeller University Newswire

Posted on February 22, 2017 by Danzig

Jeffrey V. Ravetch, Theresa and Eugene M. Lang Professor and head of the Leonard Wagner Laboratory of Molecular Genetics and Immunology, has won the 2017 Ross Prize in Molecular Medicine. The award, given by The Feinstein Institute for Medical Research and its journal Molecular Medicine, honors scientists who have made a significant impact on the understanding of human disease pathogenesis and the development of innovative treatments. Ravetch will receive a $50,000 honorarium and present a lecture at The New York Academy of Sciences on June 5.

Jeffrey V. Ravetch

Ravetch studies how a functioning immune system protects against invaders, and how a dysfunctional immune system attacks the bodys own tissues in autoimmune disease. He is widely known for his work on Fc receptors, proteins on the surface of immune cells that interact with antibodies. By binding to Fc receptors, antibodies are able to change immune cells protective activity. This interaction is critical to the immune systems ability to defend against toxins, bacteria, and viruses. Ravetchs work on the Fc receptor pathwayan essential part of the immune responsehas led to new approaches to treating autoimmune disease as well as cancer and infectious disease.

Recent work in the Ravetch lab has shed light on why some people are more vulnerable than others to developing life-threatening secondary infections from the dengue virus.

Ravetch received his Ph.D. in 1978 from Rockefeller and his M.D. from Cornell University Medical College in 1979. In 1982, he joined the faculty of Memorial Sloan Kettering Cancer Center and in 1984 also became a guest investigator in Rockefellers Laboratory of Cellular Physiology and Immunology. He was appointed professor at Rockefeller in 1996. Among his many honors are the 2007 Coley Award from the Cancer Research Institute; the Canada Gairdner International Award and the SanofiInstitut Pasteur Award, both in 2012; and the 2015 Wolf Prize in Medicine. Ravetch is a fellow of the American Academy of Arts and Sciences and the American Association for the Advancement of Science, and a member of the National Academy of Sciences and the National Academy of Medicine.

The Feinstein Institute was established in 1995 as the research arm of Northwell Health, the largest healthcare provider in New York. Now in its fifth year, the Ross Prize is awarded through the institutes journal Molecular Medicine, which addresses disease pathogenesis at the cellular and molecular levels. The Ross Prize aims to cultivate promising careers in the fields of science and research.

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Jeffrey V. Ravetch receives 2017 Ross Prize in Molecular Medicine - The Rockefeller University Newswire

CU collaboration produces health ‘game-changer’ – CU Anschutz Today (press release)

Posted on February 22, 2017 by Danzig

The patient breathes harder as his workout intensifies. His metabolic fingerprint heart rate, oxygen level and other data streams onto a tablet in the form of a colorized digital bar that shows exactly what his muscles are doing and the fuels hes burning.

In the purple zone hes stressing his anaerobic system, and in the red hes going to burn muscle mass if he stays up there too long, says Nicholas Edwards, MS, director of Exercise-Medicine Integration in the Department of Family Medicine, CU School of Medicine. The blue here represents his prime zone, where he performs best during exercise and creates the most energy, so hes safely burning the most pound for pound right at this second.

Edwards is also co-founder and chief scientific officer of METHOD, a CU spinoff company, that is proving to be a health game-changer by connecting exercise to medicine. The system gives thousands of athletes and patients access to individualized, real-time metabolic information that, when combined with a prescribed fitness regimen, builds strength and stamina, reduces injury, sheds weight and improves their response to treatment.

These metabolic data points help tailor regimens to a specific physiology whether the person be a pro athlete, weekend warrior or couch potato to provide healthy outcomes across the continuum of care. Its literally like a medically based fitness plan, says Edwards, who three years ago launched METHOD with an eye toward college and pro athletes. Among the first users were elite athletes who were patients in the Ascent Program at the Center for Dependency, Addiction, and Rehabilitation (CeDAR). The METHOD system has expanded to thousands of patients and athletes, including the NHLs Colorado Avalanche, NFL teams as well as fitness facilities and centers for orthopedics and physical therapy from coast to coast.

Besides being a breakthrough approach making exercise a prescribed medicine the METHOD app is a testament to the collaborative innovations regularly occurring on the CU Anschutz Medical Campus. Family Medicine owns a stake in the enterprise, which was assisted in its launch by CU Innovations. We collaboratively worked on a system that covers the spectrum orthopedics through physical therapy to human performance, says Edwards, who has two business partners.

Previously, there was nothing that quantified what a person in the gym, the rehab center or the weight room is doing metabolically in real-time, he says. Anaerobic exercise was a guess. Through METHOD, weve been able to identify somebodys unique metabolic fingerprint to know whats going on physiologically as they exercise.

Dan, a patient at UCHealth, went through the three stages of the METHOD system evaluation, prescription for exercise, and monitoring under Edwards supervision. Dan is a high-level crossfit competitor and works as a paramedic, so he understands the value of physiological data such as heart rate and energy thresholds. Using the METHOD data, Nick built a training program specific to my capabilities that matched my heart rate and everything, Dan says. Its been amazing. Ive gotten stronger, faster and more physically fit in the last month and a half than Ive done on my own, just kind of blind training, over the last year.

This system really dials everything in. METHOD patient

Meanwhile, people on the other end of the spectrum, the sedentary and obese, often tell Edwards they dont know how to workout, feel pain when exercising or are simply intimidated. The great thing about this system is were able to give them specific parameters to know exactly where they should exercise, the exact kind of exercise, and when to start and stop, so they change their body in a healthy and safe way, he says. This system really dials everything in.

Because the app loads onto smartphones and synchs with heart rate monitors, its able to monitor whether a user is staying in a metabolic zone too long. The phone will literally buzz and tell them to speed up or slow down their workout, Edwards says. The app has built-in coaching mechanisms across the board.

And the app acts as massive data repository that allows clinicians to view real-time data from users around the country. I can monitor somebody on an exercise prescription in Maine or in Southern California and compare their outcomes to somebody here in Colorado, says Edwards, who played college football at North Dakota State and is a former mixed martial professional. Our goal is to solidify best practices over time.

Improved outcomes mean athletes get back on the ice or field faster, while patients, either those recovering from surgery or just going through physical therapy, return to their normal lives sooner, Edwards says. The big payoff is that by optimizing patient outcomes were lowering the cost of care, because youre eliminating guesswork and duplication of services.

For example, METHOD renders obsolete the timeworn 220-minus-your-age formula for determining a persons maximum heart rate. Edwards gives the example of a 55-year-old couch potato and a former pro hockey player of the same age. If you do that old formula, they should exercise the exact same way, which is ludicrous, he says. We need to find something different thats happening with that individual every single day, and thats what we do with METHOD.

When not directly coaching athletes and patients through exercise regimens, Edwards speaks about the benefits of METHOD and proper training across the U.S. at the NFL Combine, behavioral health and strength and conditioning conferences and other events. He notes that the system is really starting to catch fire as more people turn to individualized exercise regimens.

Edwards says METHOD will further elevate CU SOMs stature as a global leader in innovation, wellness and health care outcomes. Were developing a lasting change to make medicine and exercise collaborate long term.

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CU collaboration produces health 'game-changer' - CU Anschutz Today (press release)

‘Refugees Welcome’ banner draped on Lady Liberty – USA TODAY

Posted on February 22, 2017 by Danzig

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The banner, approximately 3 feet by 20 feet, was up for over an hour before being removed. USA TODAY

An aerial view of the Statue of Liberty in New York.(Photo: Getty Images/iStockphoto)

Activistscaled the Statue of Libertyand unfurled a red and white "Refugees Welcome" banner on Tuesday, just hours after theDepartment of Homeland Securityunveiled its sweeping plan to deport undocumented immigrants across the U.S.

The banner, which measured 3 feet by 20 feet in length, was unrolled and dangled from the statue's observation deck, the National Park Service said.

The sign was removed more than an hour laterafter it surfaced, the Associated Press reported, but not before images spread like wildfire on social media:

According to CNN, an activist group called Alt Lady Liberty claimed responsibility for the banner. "Almost all Americans have descendants from somewhere else," the group told CNN. "Immigrants and refugees make this country great. And turning away refugees, like we did to Anne Frank, does not make us great."

Alt Lady Liberty posted several images of the banner on its Twitter account, with one caption reading: "The message of the Statue of Liberty is unmistakable."

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'Refugees Welcome' banner draped on Lady Liberty - USA TODAY

"Refugees welcome" banner hung on Statue of Liberty – CBS News

Posted on February 22, 2017 by Danzig

A banner reading Refugees Welcome was hung from the Statue of Liberty on Tuesday, Feb. 21, 2017.

CBS New York

NEW YORK --The National Park Service is trying to figure out who unfurled a giant banner at the Statue of Liberty saying Refugees Welcome.

Park Service spokesman Jerry Willis says the 3-by-20-foot banner was hung from the public observation deck at the top of the statues pedestal Tuesday afternoon.

Park rangers determined it could be removed without damaging the statute and began the process of taking it down, CBS New York reports. The banner was taken down more than an hour later.

Affixing a banner to the national monument is strictly prohibited, and an investigation is underway by the United States Park Police to identify suspects, the agency said in a statement.

Its not illegal to bring a banner onto Liberty Island, but it is against the law to hang anything from the monument.

The stunt happened the day the Department of Homeland Security announced expanded immigration enforcement policies.

"Refugees welcome" banner hung on Statue of Liberty - CBS News

Young Americans for Liberty on Mission to Restore Free Speech in … – Fox Business

Posted on February 22, 2017 by Danzig

Young Americans for Liberty is on a mission to protect the values of the First Amendment and restore free speech to college campuses across the United States.

We are not just whining about it, we are not just talking about it. Its a battlefield out there on college campuses, Cliff Maloney Jr., the President of the conservative group Young Americans for Liberty, told FOX Business Stuart Varney.

Maloney said the fight is against the unconstitutional speech codes used by the left, which prevents conservatives from expressing their idea of freedom.

We launched something called the The National Fight for Free Speech Campaign to go out and combat these anti-free speech zones that we are finding on campuses throughout the United States. This is the way that big government bureaucrats are able to really shutdown libertarian and conservative students, he said.

The organization is on a rapid growth chart with 900 chapters and over 300,000 members across America mobilizing for the principles of liberty and constitutional government.

According to Maloney, 247 of the organizations 900 chapters have speech codes that limit their ability to organize.

Continue Reading Below

Our student chapters are out there trying to express the message of freedom, trying to bring to people to the idea that government cant always be who we turn to for the solution. We need to turn to individuals and be innovative, he said.

As a millennial, Maloney said his generation has grown up with a government that has sacked them with an increasing amount of debt while continuously violating the Fourth Amendment.

We are presenting a different message. We are recruiting and bringing people to the idea, once again, that government is the not the solution, he said.

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Young Americans for Liberty on Mission to Restore Free Speech in ... - Fox Business

Northide boys basketball versus Liberty – Roanoke Times

Posted on February 22, 2017 by Danzig

Northside can score in bursts.

For proof, look no further than the second quarter of the Vikings 66-56 win over Liberty in the 3A West quarterfinals.

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Northide boys basketball versus Liberty - Roanoke Times

116 W. Liberty St., Savannah, remodeled townhome – Savannah Morning News

Posted on February 22, 2017 by Danzig

Empire Construction is a Savannah-based construction company specializing in residential, commercial and restoration projects.

Empire recently completed a remodel of the top floor unit in the Solomon Cohen Townhouse, located at 116 W. Liberty St. in downtown Savannah.

Nestled among Savannahs beautiful squares, the residence was originally built by prominent Savannah lawyer Solomon Cohen as a wedding present for his daughter in 1875, the same year as his death. The 1,300 square foot, two-bedroom, one-bath condominium fully occupies the buildings top floor and features beautiful hardwood floors with an abundance of natural lighting. The owners plan to utilize it initially as a vacation rental.

Following Empire Constructions work, the condominiums kitchen and bathroom now boast attractive new tile work as well as updated fixtures and appliances. The kitchen has been enhanced with new backsplashes and modern lighting. Empire Construction was referred by Realtor Danni Evans Powers at Cora Bett Thomas Realty. She worked at length to find the perfect property for current homeowners Jennifer Fischer and Reggie Crawford. Fischer and Crawford are pleased with the results, noting the updates really make the condominium shine.

The Empire Construction team was incredibly professional and we love the end result, Fischer said. The work was competed with care and you can see the quality of the work throughout our home. We were kept informed of the progress along the way and they treated our home like their own. It was clear that the quality of work and attention to detail were held to a very high standard that was more than we expected.

Empire Construction provides honest and reliable service that exceeds expectations by ensuring that each project is completed on time and within budget. By utilizing state of the art equipment and the latest techniques combined with the use of the highest quality materials, Empire Construction is able to ensure exceptional workmanship that is highly durable and cost-effective. As a general contracting firm, Empire Constructions services include bathroom remodels, cabinet installation, commercial construction, commercial remodel, drywall installation, flooring installation, green building construction, historic restoration, home additions, kitchen remodels, trim installation and new construction.

For more information about Empire Construction or to view galleries of completed projects, please visit http://www.empire-builds.com.

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116 W. Liberty St., Savannah, remodeled townhome - Savannah Morning News

Carriers Move to Accommodate Increased Demand for Canary Islands – Skift

Posted on February 22, 2017 by Danzig

Hoteliers in Spains Canary Islands are being urged to accelerate the construction of new holiday properties as a spree of terrorist attacks in the Mediterranean prompts airlines to switch capacity to markets perceived as safer by tourists.

Tenerife, the biggest of the islands and the most popular with visitors, effectively ran out of beds over the winter, while a general shortage of accommodation pushed up room prices as much as 15 percent, according to Sophie Dekkers, UK regional manager at discount carrierEasyJet Plc. That increase is expected to continue into the summer, she said.

The position of the Canaries off Moroccos Atlantic coast makes the archipelago a year-round destination for sun-loving north Europeans, and a natural candidate for extra flights following the attacks in North Africa, Turkey and the French Riviera. EasyJet has also held talks with the Greek Tourism Board on extending the holiday season there, while tour operator Thomas Cook Group Plc is adding capacity in markets including Bulgaria, Croatia, Cyprus and Portugal.

Weve been working very closely with the Canarian government to talk about accelerating hotel projects, Dekkers said in an interview at London Gatwick airport, where Luton, England-based EasyJet has its biggest hub. We know the demand is there, lets make sure the hotels are being built, make sure theyre getting support so they can be completed.

EasyJet is also evaluating new routes to the Canaries targeting areas less well known to Britons. Those include the northwest island of La Palma, which it currently serves only from Gatwickand which traditionally attracts more German tourists, and Tenerife-North, located on the other side of the island from the larger resorts and currently more popular with Spanish visitors.

Like Thomas Cook andTUI AG, the discount airline also plans to expand in the Balkans, adding frequencies to Croatia, starting a new route to Montenegro and evaluating flights from the U.K. into Bulgaria. Its also reviewing service levels to some Turkish beach resorts where demand may be beginning to recover as traveler concerns focus more on major cities.

The U.K., which accounts for about 40 percent of EasyJets revenue, is currently exhibiting high single-digit growth, Dekkers said. While thats on a par with the airlines other operations, its slightly behind previous years, when Britain tended to offset slower expansion elsewhere, she said.

Inbound travel hasnt been as strong as initially anticipated after the pound slumped in the wake of Junes vote to quit the European Union, making the U.K. a cheaper destination for visitors. That suggests travelers from other EU states fear theyll be less welcome, or that concerns about attacks on London are acting as a disincentive, Dekkers said.

Tickets for next winter will go on sale in the next month and should indicate if a slump in fares is starting to level off, she said, as well as provide pointers as to whether carriers are beginning to limit seat supply.

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Carriers Move to Accommodate Increased Demand for Canary Islands - Skift

Road Warrior: City keeping Warren Avenue pedestrian islands – Kitsap Sun

Posted on February 22, 2017 by Danzig

Kitsap Sun Published 10:18 a.m. PT Feb. 21, 2017 | Updated 6 hours ago

The in basket: John Bogen asks, Will the city ever review the poor decision made to put the pedestrian islands in on Warren between Burwell and Sixth? It is a mess at 4 p.m., and I often see people driving through the gaps westbound on Fourth and Fifth in order to bypass the Burwell and Warren traffic jam (caused by the islands).

I think the islands make it more difficult to see pedestrians at 4-5 p.m. in the dark/twilight, and they plug up traffic horribly. A better and cheaper solution would have been to install flashing crosswalk lights for the relatively few pedestrians who use those crosswalks. Anyhow, is there ever any review following a traffic enhancement such as this?

The out basket: I didnt think there was much chance of a change of heart on this, as the city is pretty committed to making life easier and safer for pedestrians and bicyclists at the expense of motorists.The center barriers cut in half the distance a pedestrian must walk to cross Warren in one movement. And the third gap in that barrier at Fifth and Fourth, in addition to those with crosswalks in them, is legally available to bicyclists, who likewise have a refuge area half-way across.

Shane Weber, street engineer for the city, confirmed my expectation. We have no plans to review the center island improvements on Warren Avenue, he said. We are aware that there are instances where people will try to make the illegal maneuver through the gaps in the island.However, we believe this occurrence to be minimal and have made Bremerton Police Department aware for enforcement.

The city is reviewingsignal timing this year on the Warren Avenue corridor. There may be timing adjustments we make to the signals along the corridor if it is determined better performance can be achieved. This includes the signals at Warren Avenue and Burwell and Warren Avenue and Sixth Street.

Have a question for the Road Warrior? Call 360-792-9217 or email tvisb@wavecable.com.

Read or Share this story: http://www.kitsapsun.com/story/news/local/2017/02/21/road-warrior-city-keeping-warren-avenue-pedestrian-islands/98201416/

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Road Warrior: City keeping Warren Avenue pedestrian islands - Kitsap Sun

How the Benesse Art Site Naoshima Revitalized a Cluster of Japanese Islands – Architectural Digest

Posted on February 22, 2017 by Danzig

Yayoi Kusamas polka-dotted pumpkin overlooking the ocean, James Turrells Open Sky installation, and an entire art space by Walter De Maria are just a few of the groundbreaking works on display at Benesse Art Site Naoshima, a cluster of once-polluted islands in Japans Seto Inland Sea rehabilitated by contemporary art and architecture by Tadao Ando, Sanaa, and Hiroshi Sambuichi. Like Dia:Beacon in New York and the Chinati Foundation in Marfa, Texas, Naoshima is a pilgrimage site for contemporary art lovers and a place where locals can immerse themselves in art outside of the traditional galleries and museums. I was born in a rather rural area, so I love nature, Soichiro Fukutake, the billionaire arts patron and honorary adviser to Benesse Holdings, says. So rather than installing art in white cube museums, I like to install art in nature, art with strong messages, contemporary art especially, and find the right environment and the right architecture.

Full Moon Stone Circle by Richard Long at Benesse House Museum in Naoshima.

Photo: Education Images/UIG via Getty Images

Founded in 1989, the Benesse Art Site Naoshima continues to grow and develop, with new installations coming to some of the islands, including Teshima and Inujima. During Singapore Art Week in January, Fukutake awarded the inaugural Asian edition of the Benesse Prizegiven at the Venice Biennale since 1995to Thai artist Pannaphan Yodmanee, whose monumental installation is one of the highlights of the Singapore Biennale. Aftermath, which juxtaposes symbols of Buddhist cosmology with representations of modern urban decay, is on view at the Singapore Art Museum through February 26. Yodmanee has been commissioned to create a site-specific work for the Benesse Art Site Naoshima, becoming one of just a handful of Southeast Asian artists represented there. I think we are going to be in the age of Asia going forward, and theres a lot of disparity between rural and urban areas in Asia, Fukutake says. And I thought we could bring our approach of rejuvenating and building rural communities through art starting with Singapore and then broadening and roll out this approach through other parts of Asia.

Close-up of Karel Appel's Frog and Cat sculpture in Naoshima.

Photo: Education Images/UIG via Getty Images

Having made his fortune at the Benesse Groupa leader in education, language training, and senior careFukutake ranks among Japans 50 wealthiest individuals and is one of the worlds most influential art collectors, advocating for contemporary art as a way to uplift rural areas. To share with you my personal view, contemporary art should not be just something that people collect or invest for speculative purposes. We dont do that; I dont do that. I want to do something to close the disparity between urban areas and rural areas, Fukutake says. Asia has a lot of billionaires who are building their wealth, and Im hoping that a lot of such Asian billionaires can commit to such initiatives by using contemporary art to help rebuild rural communities. He advocates a new form of philanthropic capitalism that he calls public interest capitalism, in which corporations establish a foundation that can use dividends to promote culture and the arts.

Benesse House Museum in Naoshima.

Photo: Education Images/UIG via Getty Images

His own interest in art originated with his father, who collected works by Japanese-American artist Yasuoi Kuniyoshi. When I got involved in directing Naoshima, the first museum that impacted me was the Louisiana Museum in Denmark near Copenhagen, Fukutake says, adding that Dia:Beacon, the Rothko Chapel in Houston, Walter De Marias Lightning Field in New Mexico, and James Turrells Roden Craterwhich he visited with the artistinfluenced him, too. Thanks to his efforts, the Benesse Art Site Naoshima continues to inspire art lovers and architecture fans from around the world. There are a lot of interesting Asian artists emerging now, and many Asian countries are in the process of developing, he says. Visitors to the islands can be sure to see more exciting work by contemporary Asian artists soon.

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How the Benesse Art Site Naoshima Revitalized a Cluster of Japanese Islands - Architectural Digest

Conservation Minister heads to Auckland Islands – Radio New Zealand

Posted on February 22, 2017 by Danzig

The Conservation Minister is visiting sub-antarctic islands to see what a predator-free New Zealand would look like.

Sandy Bay on Enderby Island, in the Auckland Islands group (file) Photo: RNZ / Alison Ballance

The navy patrol ship Otago has just left Bluff on a four-day trip to the Auckland Islands after waiting overnight for the minister, Maggie Barry, who was delayed by fog.

The Auckland Islands are the main breeding colony for endangered New Zealand sea lions and some albatrosses, and are largely free of mammalian pests.

The government has set a target of the country becoming predator-free by 2050.

Ms Barry said the trip would help towards that goal.

"I want to see first-hand what New Zealand will look like when the predators are gone, and that's what we'll see on some of these islands.

"The bird life and the capacity for nature to heal itself is what really will resonate with me."

Minister of Conservation Maggie Barry aboard the HMNZS Otago, ready to leave for the Auckland Islands. Photo: RNZ / Ian Telfer

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Conservation Minister heads to Auckland Islands - Radio New Zealand

CZECH AMBASSADOR KEEN TO BROADEN TIES WITH SOLOMON ISLANDS – Solomon Star

Posted on February 22, 2017 by Danzig

Solomon Star

CZECH AMBASSADOR KEEN TO BROADEN TIES WITH SOLOMON ISLANDS
Solomon Star
GCU: The new Czech Republic's non-resident Ambassador to Solomon Islands, His Excellency Martin Pohl says he is keen to broaden ties with Solomon Islands when he met Prime Minister Manasseh Sogavare today (Tuesday 21st February). At a brief ...
Czech Republic keen to broaden ties with Solomon IslandsRadio New Zealand
Stronger Ties Pledged Between Solomon Islands and South KoreaEMTV Online

all 3 news articles »

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CZECH AMBASSADOR KEEN TO BROADEN TIES WITH SOLOMON ISLANDS - Solomon Star

‘Medicare for All’ Only Way for Trump to Keep Healthcare Promises – Common Dreams

Posted on February 22, 2017 by Danzig

Common Dreams

'Medicare for All' Only Way for Trump to Keep Healthcare Promises
Common Dreams
But "single-payer reform could," write the co-founders of Physicians for a National Healthcare Program (PNHP). "Such reform would replace the current welter of insurance plans with a single, public plan covering everyone for all medically necessary ...

and more »

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'Medicare for All' Only Way for Trump to Keep Healthcare Promises - Common Dreams

Truth Test: Does Coffman have a plan to fix healthcare? – 9NEWS.com

Posted on February 22, 2017 by Danzig

Brandon Rittiman, KUSA 7:08 PM. MST February 21, 2017

(Photo: American Action Network)

KUSA - While we haven't seen a concrete plan from Republicans to replace Obamacare, the replacement is already getting rave reviews -- at least in TV ads supporting GOP members of Congress.

The "American Action Network," which doesn't disclose its donors, is running one such ad in Colorado.

It's technically an issue ad, suggesting you call Congressman Mike Coffman to give him an "attaboy" for working on healthcare.

CLAIM: Our healthcare system isn't working. Mike Coffman has a plan to fix it. VERDICT: Overstatement

Mike Coffman doesn't have a plan to replace Obamacare, but his staff points out he "does have some very specific principles that he expects to see included in the plan to replace the Affordable Care Act."

That is not the kind of thing you'd write if the plan was actually done.

In fairness to Coffman, this isn't an ad *he* made.

But he is meant to benefit from it.

And if the ad is a bit over-the-top in singing Coffman's praises about changing healthcare laws-- well, at least he's got plenty of company.

This same ad is running claiming that several other congressional Republicans also have plans in TV ads running in other states.

Theres also a generic version that simply promises Republicans have a plan.

And the group cut versions of the ad with the same visuals, but with scary music and a more somber voiceoverattacking Democrats who supported Obamacare.

So the key message here is that whatever Republicans come up with, the American Action Network group thinks it's gonna be great.

CLAIM: [Obamacare has led to] rising premiums and deductibles. VERDICT: True, but needs context

It's true premiums and deductibles have increased since Obamacare, but this needs a little context: premiums and deductibles were also increasing before Obamacare.

CLAIM: [Obamacare has led to] Washington intruding between doctors and patients. VERDICT: Too vague to test

Without a more specific claim, this is too vague for us to factcheck.

One could argue this has been the case for more than a century-- since the first time Congress passed a law on healthcare.

CLAIM: [Obamacare has led to] expensive mandates that destroy jobs. VERDICT: Fair

While the ad-makers can point to a study from their own think tank, we can look at more neutral sources to find evidence to support this claim.

The New York fed surveyed companies and found roughly one in five cutting jobs in the service and manufacturing sectors in response to Obamacare.

There's also evidence a relatively small number of workers were dialed back to part time due to the A-C-A.

Despite all that, it's worth pointing out that the national jobs reports have been steadily improving with the broader economic recovery.

The idea that we can experience job growth and the idea that healthcare policy might cause some companies to dial back on their hiring plans are not mutually exclusive.

PROMISES, PROMISES

The ad goes on to make several promises about what will be in the new plan, which does overlap with what congressman Coffman's office told us he wants to see.

Many of the promises in the ad mirror policies already enacted by Obamacare, such as addressing pre-existing conditions, tax credits to help people buy insurance, and targeting small businesses to pool their resources.

Coffmans office told us he wants to keep the changes Obamacare made for pre-existing conditions, the ability for parents to keep children on their plans until age 26, and maintaining coverage for people who gained it under the ACAincluding the Medicaid expansion, which has been criticized by some of Coffmans fellow Republicans.

In any case, we've seen some G-O-P proposals to replace Obamacare, but since they haven't settled on one we can't really fact check those promises yet.

BOTTOM LINE

And that gets us to the bottom line: this ad is glossing over the fact Republicans have yet to unite behind a plan on healthcare in an effort to make you think it's going to be awesome, no matter what plan they end up with.

( 2017 KUSA)

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Truth Test: Does Coffman have a plan to fix healthcare? - 9NEWS.com

Want to live longer? Move to a country with universal health care, study finds – The Mercury News

Posted on February 22, 2017 by Danzig

LONDON While most people born in rich countries will live longer by 2030 with women in South Korea projected to reach nearly 91 Americans will continue to have one of the lowest life expectancies of any developed country, a new study predicts.

Scientists once thought an average life expectancy beyond 90 was impossible but medical advances combined with improved social programs are continuing to break barriers, including in countries where many people already live well into old age, according to the studys lead researcher, Majid Ezzati of Imperial College London.

I can imagine that there is a limit, but we are still very far from it, he said.

Ezzati estimated that people would eventually survive on average to at least 110 or 120 years. The longevity of South Korean women estimated in 2030 is due largely to investments in universal health care, he said. South Korea also led the list for men.

Its basically the opposite of what were doing in the West, where theres a lot of austerity and inequality, he said.

Ezzati and his co-authors used death and longevity trends to estimate life expectancy in 35 developed countries. The calculation is for a baby born in 2030. The study was published online Tuesday in the journal Lancet.

Women were ahead of men in all countries. Behind South Korea, women in France, Japan, Spain and Switzerland were projected to live until 88. For South Korea men, life expectancy is expected to reach 84. Next were Australia, Switzerland, Canada and the Netherlands at nearly 84.

At the bottom of the list: Macedonia for women at nearly 78, and Serbia for men at about 73.

While some genetic factors might explain the longevity in certain countries, social and environmental factors were probably more important, Ezzati said.

The study estimated that the U.S., which already lags behind other developed countries, will fall even further behind by 2030, when men and women are projected to live to 80 and 83. American women will fall to 27th out of 35 countries, from their current ranking of 25, and men will fall from 23rd to 26th.

The researchers note that among rich countries, the U.S. has the highest maternal and child death rates, homicide rate and is the only high-income country without comprehensive health care. The researchers also predicted how much longer 65 year olds in 2030 would live; they guessed that among men, those in Canada would live the longest, surviving another 23 years. Among 65-year-old women in 2030, they estimated that South Koreans would live the longest, another 28 years.

In an accompanying commentary, Ailiana Santosa of Umea University in Sweden wrote that the projections raise crucial issues about which strategies are needed to tackle worsening inequality problems.

Achieving universal health coverage is worthy, plausible and needs to be continued, she said.

The study was paid for by the U.K. Medical Research Council and the U.S. Environmental Protection Agency.

Originally posted here:

Want to live longer? Move to a country with universal health care, study finds - The Mercury News

The Republican Health Care Plan: Do the Promises Add Up? – Knowledge@Wharton

Posted on February 22, 2017 by Danzig

Health insurance reform will be high on the agenda as the U.S. House of Representatives reassembles after Presidents Day. Cutting through the high-decibel pitches from supporters and critics of the Affordable Care Act (ACA), experts discern a leaner alternative taking shape.

A Republican policy brief notes that under the ACA, or Obamacare, premiums have risen an average of 25% this past year and that nearly a third of all U.S. counties have uncompetitive markets with only one insurer offering plans. It faults the Medicaid program for being too bloated and rendered less effective by fraud, waste, poor oversight and by being misdirected at able-bodied people instead of more vulnerable sections of the population.

The Republican plan put forth last week offers an alternative, promising lower costs, more choices and flexibility for employers in the plans they may offer and also for individuals, who would be able to buy insurance across state lines and also obtain coverage regardless of age, income or pre-existing medical conditions.

Highlights of the Republican plan include: portable, monthly tax credits that can be used towards buying insurance, and that are not tied to employers or to a government-mandated program. Individuals can use the credits to shop for health insurance plans across state lines. It includes a measure to expand Health Savings Accounts (HSAs), which would offer more freedom for contributions by individuals and their spouses, and more flexibility in terms how they spend their savings.

It promises Medicaid reform by empowering states to design their own plans and by putting the program on a tighter budget, something critics read to mean sharp cuts in federal funding with block grants to states to run Medicaid, many of whom would want to make cuts overall. The policy brief offers no details as yet, but that is because the Congressional budget office is reviewing the plan. The latest proposals are based on House speaker Paul Ryans plan that he unveiled last year.

The biggest detail is the little question of money, said Robert Field, Wharton lecturer and professor of law and health management at Drexel University. He referred specifically to a proposal to grant tax credits based on age instead of income: How big they will be everyones expecting they will be less generous than under Obamacare. Age-based tax credits would replace the ACA feature where subsidies kept pace with premium increases so that employees could continue to afford them. Delinking those subsidies from income criteria and linking them with age changes those protections.

Katherine Hempstead, senior advisor to the executive vice president at the Robert Wood Johnson Foundation, pointed to what she described as two semi-contradictory things going on at once. On one hand, the motivation in changing the age rating could allow insurers to charge more for older people and charge less for younger people, she said. At the same time, subsidies for older people are aimed making health insurance more affordable to them, she added.

Do the taxpayers want to be moderately generous to many or highly generous to a few? Mark Pauly

The hope then is that policies for younger people would be affordable enough, and the take-up rates of people buying those policies would improve, said Hempstead. But she didnt expect the Republican alternative to pan out exactly that way. Many people suspect that the lower-income part of the market is going to drop out, she noted. That is going to have huge implications for the risk pool if that happens. I dont know how affordable these policies will be for anybody.

Field and Hempstead discussed the pros and cons of the Republican health care proposals on the Knowledge@Wharton show on Wharton Business Radio on SiriusXM channel 111. (Listen to the podcast at the top of this page.)

Age vs. Income

At first glance, the move to link subsidies to age and not income seems the right approach. The reason to have subsidies independent of income is to avoid the relatively high implicit tax on income of Obamacare recipients when your subsidy goes down as your income goes up, said Mark Pauly, Wharton professor of health care management, and business economics and public policy. He noted that the implicit tax rates were above 100% for some groups.

However, making the subsidy a flat amount regardless of income at a level that still provides adequate help to lower-income people could have adverse effects, according to Pauly. It means very high additional taxes which also discourage work effort of everyone, not just the 3% of the population buying in exchanges, he said. Or you can set the subsidy low which keeps taxes down but will leave more low income people uninsured. That situation would arise because the premium those low income people would have to pay will be much more than the average amount they would have to pay if they were uninsured and received charity care, he explained.

So they have a serious dilemma, Pauly noted. Do the taxpayers want to be moderately generous to many or highly generous [in a targeted way] to a few? And probably the credits will be claimed more by the reasonably well-off rather than the lower-income people who will stay out.

Removing tax exemptions for employer-sponsored plans will be more efficient because then there will be neutral incentive for people getting insurance through their job or in the individual market, said Pauly. He did not expect large firms with good benefits departments to change their policies, but it may cause some smaller firms to switch to paying more cash wages and having workers buy their insurance as individuals. He noted that individual insurance is administratively about five times costlier by than large group insurance.

Hempstead noted that the absence of penalties for not buying health insurance would not help increase take-up rates, either. If subsidies are based solely on age and not on income, you will have lower-income younger people particularly those who are 26 or 27 years old who have just moved on from their parents policies who will not be able to afford [coverage] and we will lose them from the market, she said. She saw an inherent unfairness in lower-income younger people not getting much in the way of subsidies, while older people who are quite wealthy would qualify for them.

According to Hempstead, the Republican plan is much less redistributive than the ACA is, especially as it relates to deepening risk pools to gain more efficient pricing. The market is very heavily juiced with public money, she said. If you pull a lot of that public money out, there will be consequences. Such a scenario would also bring up anti-poverty issues, she added.

An End to Employer-sponsored Coverage?

Moves to remove tax exemptions for people in employer-sponsored plans face opposition from unions and employers who use health insurance as an incentive in recruiting, but many on both sides of the political aisle see those bringing longer-term gains. The idea is that people would get more of their compensation in the form of wages and less in the form of health insurance benefits, said Hempstead. That would lead people to ultimately chart a course away from employer-sponsored insurance which after all is just an historical artifact that a lot of people have gotten used to, but there is no particular reason that your employer should be taking out your health insurance for you.

If there are a lot of really dire projections about people getting thrown out of coverage and about affordability issues, its not going to be simple. Katherine Hempstead

Hempstead pointed to arguments that reducing those tax exemptions would eventually help create a much larger and more vibrant individual market. She thought that scenario would also solve problems in making risk pools more efficient. But other people are naturally very wary about that, including large employers who see it as a major recruitment strategy and are uncomfortable about transitioning to a phase where they are not the providers of those benefits.

Field characterized that proposal as just the Cadillac tax from the ACA in another name. Under the so-called Cadillac tax that is set to take effect in 2020, insurers will have to pay an annual 40% excise tax on high-end employer-sponsored plans that have annual premiums exceeding $10,200 for individuals or $27,500 for a family. The idea is to make it less attractive to give overly generous plans which encourage people to over-use medical services, he said. [The Republicans] are taking something from Obamacare that amounts in a way to a tax increase and firing the shots in terms of making it into policy.

Hempstead noted that there is a lot of bipartisan support and empathy for this, adding that she, too, agreed with it. I thought the Cadillac tax was a move in the right direction, even if there were some other ways it could be modified.

Will Wages Really Increase?

However, employees worry that the removal of the tax exemption for their health insurance premiums may not be replaced fully by higher wages, Hempstead said. Another concern is whether they would be able to find good alternative products if they were to lose coverage from their employers. In any event, she noted that many people see the push towards employees buying their own health insurance as inevitable, although [it] isnt going to be an overnight change. She pointed to some moves already underway in the direction of direct-to-consumer markets, such as with the Medicare Advantage plans and the growth of private exchanges.

Field was skeptical about how the transition to a removal of the tax exemptions would protect employee wages. If employers stop [offering health coverage] and say they will give employees the money rather than the health insurance, would it be a one-for-one exchange? he asked. Would they give you all of the money they would have given the insurance company? I think the answer is no, but how much of it would they give you? Would workers actually see an increase in their paychecks?

Employees would be worse off in that any wage increase would be taxable, which means they would have less money on hand to buy their health insurance, Field noted. That could have the effect of leaving policies less generous than earlier. It would have a profound effect on the structure of health finance and health care provisions because the flow of money would change.

It is imperative to have a well-functioning health insurance market for those changes to work, said Field. If that is where we are going, then we better have a pretty vibrant individual market, he argued. Whatever they do to change those markets better hold up, because we are throwing people into them and if they cant buy policies there, where are they going to go?

Getting Medicaid Right

Money is again central to the plans to reform Medicaid, said Field. He noted that the Trump administration could provide states block grants to manage that program, perhaps on a per-capita basis. If they do that with enough money, maybe the system will be better, because states could innovate more, he said. If they do that without enough money, which is what the critics fear, this could be a major cutback and could lead to a lot of people losing their health coverage.

The outcomes of a badly run Medicaid program could be serious, according to Field and Hempstead. Field notes that Medicaid is unloved; everyone likes to take hits at it, but it is the backbone of our safety net hospitals, of our pediatric hospitals. Its influence is beneath most peoples radar, but its throughout the system, so if you tinker with it, a lot of harm can be done. Hempstead noted that Medicaid is the single-biggest category with 72 million people enrolled in it. Its a huge lifeline for a lot of providers and [has] widely different beneficiary groups, she said. [They are] kids, pregnant women and healthy adults, but also some very sick people, the aged and disabled.

If there is a way to provide more coverage for less money, then [Trump has] got a brand new business line, even better than resorts and hotels. Robert Field

A policy of caps on per-capita funding for Medicaid must consider how appropriate it is for groups with varying per-capita expenditures, and how those patient populations grow over time, Hempstead said. You can think about some really bad scenarios, especially for the very vulnerable populations of the aged and disabled, and also some huge shifting of burdens on family caregivers as the programs run out of money, she added. She noted that many states expanded their Medicaid offerings in recent years to fix deficiencies. Now you can imagine a lot of transitions that wont necessarily bode well for vulnerable people.

The Road Ahead

Health insurance costs could also be tamed by people adopting healthier lifestyles, Field said. He noted that the ACA included provisions to encourage prevention, including making preventive services available with no co-pays or deductibles. It also fostered innovation in payment models. For example, providers get incentives where they are rewarded more for the health of their population than for the number of services that they provide.

But achieving all that is not easy, Field said. How do you change behavior? Were not going to shut down McDonalds, were not going to outlaw cigarettes, and were not going to force you to go to the gym, he explained. There are limits to how far the nanny state can go. Additionally, even if people make those lifestyle changes, it would take 20, 30 or 40 years before their effects are seen on the health care system, he added.

More on the immediate horizon, Hempstead said there is no certainty that the Republican proposals would become reality. Its not clear there are the votes for this, she added. If there are a lot of really dire projections about people getting thrown out of coverage and about affordability issues, its not going to be simple. Field said he expected heated debates in the town hall meetings over the proposals. A lot of people now are scared and angry that they will lose their health coverage, and that will have a big effect on what Congress ends up doing.

Field, too, is not sure the Trump administration will find a way to make the various disparate objectives of the new plan coalesce into a workable alternative. If [Trump] has a magic formula, then that is amazing, he said. If there is a way to provide more coverage for less money, then hes got a brand new business line, even better than resorts and hotels. If he can do it, great, but [it is] just a little bit dubious. Added Hempstead: Were taking public money out of the market, which is not going to bode well for people that get coverage and for the markets to really thrive.

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The Republican Health Care Plan: Do the Promises Add Up? - Knowledge@Wharton

France’s Fillon mellows on health care reform – POLITICO.eu

Posted on February 22, 2017 by Danzig

French presidential candidate Franois Fillon | Lionel Bonaventure/AFP via Getty Images

Embattled center-right candidate waters down policy proposals.

By Natalie Huet

2/21/17, 1:09 PM CET

Updated 2/21/17, 9:40 PM CET

Frances beleaguered Franois Fillon sought to win back voters Tuesday by promising free glasses, hearing aids and dentures.

The center-right presidential candidate had been widely expected to win the election in May until he tripped on plans to slash health spending, and on a major scandal over payments to his wife and children.

Eager to regain the ground that polls suggest hemay have lost to far-right leader Marine Le Pen and independent candidate Emmanuel Macron, Fillon has now seriously softened his pitch for health care reform.

There is no question of touching public health insurance, even less privatizing it or lowering its coverage, Fillon tolda conference hosted by the Mutualit Franaise, the French federation of non-profit complementary health insurers.

Fillonplans to fully reimburse eyeglasses for children starting this year, he told Le Parisien newspaper and to negotiate a new deal with private health insurers to better cover hearing aids and dental implants. The aim isto bring household out-of-pocket costs for these productsas close as possible to zero by 2022, he said.

Former economy minister Macron, who has yet to unveil a detailed campaign manifesto, was quick to point out that he had been the first candidate to promisefull reimbursement of glasses, hearing aids and dental implants in the next five years.

Theyve been telling me, you dont have a platform but somehow it gets copied, he quipped.

Macron also wantstoinvest 5 billion in over-stretched hospitals whileboosting prevention and access to primary doctors. By relying more on outpatient care,heforesees15 billion in spending cuts over five years.

Fillon initially came under fire this fall over his radical plan to limit public health insurance to serious and chronic diseases. By Christmas, he had backpedaled on the proposal, deleted it from his website and took his whole health care reform back to the drawing board.

The former prime minister still plans to slash 20 billion in health care costs over five years by focusing on efficiency gains, capping health spending growth at 2 percent per year and ensuring patients have better access to primary care doctorsso they dont rush to hospitals to seek care.

But hesought to show he was far from caricatures and open-minded about how to make Frances generous health care system more sustainable. If elected, he said he plans to call a major conventionat the end of the year to discussits future with all the stakeholders concerned.

This article has been updated.

France's Fillon mellows on health care reform - POLITICO.eu

Health care for kids – The Register-Guard

Posted on February 22, 2017 by Danzig

The Cover All Kids bill now before the Oregon Legislature has worthy goals, but its likely to face strong opposition from many voters.

House Bill 2726 would ensure that all kids have access to health care as a basic human right. Currently, an estimated 17,600 children about 2 percent of children in the state arent covered for injuries, even serious ones; illnesses, including communicable ones; or preventive care.

The bill is already facing opposition on two fronts: 1) The children targeted by the Cover All Kids bill are currently uninsured because they are not legal residents. 2) This expansion of health care benefits would come at an estimated cost of $55 million over the next two years at a time when Oregon is facing a $1.8 billion budget gap.

Its hard to imagine that any Oregonian would walk by a suffering child without wanting to help or would demand to first see proof of legal residency.

But most voters arent being faced with an actual child, only the abstract idea of illegal children receiving free insurance through the Oregon Health Plan, the states version of Medicaid. To make it worse, the state would have to cover the full cost of insuring these children, as opposed to the rest of Oregons 1 million Medicaid recipients, whose health-care costs are mostly paid by the federal government.

Gov. Kate Brown told the House Committee on Health Care on Monday that money from the general fund already has been allocated for this purpose. Shes now going to have to convince legislators and voters that this is the best use for the money.

It helps that the bill has bipartisan support, but that doesnt mean its a slam dunk.

The bill and its counterpart Senate Bill 558 have been tagged with emergency clauses, which means that if they pass theyll go into effect immediately, instead of 90 days after the session ends, and cant be referred to voters.

But if voters already annoyed by the Legislatures abuse of emergency clauses in the last session are upset enough about HB 2726 and SB 558, they can still act to repeal them if they are passed. This would have to be done by forcing an initiative vote not a quick and easy process, but not an impossible one.

And voters in the past have said no to some measures that would aid illegal immigrants, such as one to allow them to have Oregon drivers licenses.

Supporters of the expansion of health care to undocumented children need to think about how to make their case to the voters by appealing not just to their emotions, but to logic and self-interest.

They need to talk about the larger cost both financial and to public health of not providing health care to almost 18,000 children. This includes preventing and treating communicable illnesses and providing care before a health issue worsens and costs more to treat or repair. Coverage also reduces the number of people who rely on emergency rooms for their care or who are unable to pay medical bills, both of which increase overall health-care costs.

Some opponents of the bills objected to them on the grounds that providing health care to children will increase illegal immigration. In reality, the majority or illegal immigrants to the United States are working-age adults, with almost two-thirds ages 25 to 44, according to procon.org, a nonprofit research organization. And illegal immigration from Mexico, the largest single source of illegal immigration to Oregon, has declined as Mexicos economy has improved, falling to a near-historic low in 2015.

If Oregonians want to decrease illegal immigration, their best option is to lobby their representatives in Washington, D.C., to maintain strong trade relations with Mexico not withhold health care from children. That hurts, not helps, the state.

Town Hall On Health Care To Go Ahead With Or Without Issa – KPBS

Posted on February 22, 2017 by Danzig

Credit: Courtesy of Rep. Darrell Issa

Above: Rep. Darrell Issa, R-Vista, is shown in this undated photo.

Aired 2/21/17 on KPBS News.

Rep. Darrell Issa, R-Vista, may not attend a town hall meeting on health care in Vista Tuesday night, but organizers said they will go ahead without him.

UPDATE: 10:43 a.m., Feb. 21, 2017

Rep. Darrell Issa (R-Vista) may not attend a town hall meeting on health care in Vista on Tuesday, but organizers said they will go ahead without him.

A coalition of local and statewide groups, including faith leaders, community health advocates and labor groups have called the town hall. They invited Issa and took out a full-page advertisement in The San Diego Union-Tribune after they did not hear back from him.

RELATED: Rep. Issa's Constituents Call On Him To Attend Town Hall On Health Care

Organizers said the event is the second in a series of statewide town halls to draw attention to the danger of repealing the Affordable Care Act without a replacement plan.

They said 300 people attended a town hall in Modesto last week, hoping to hear from their representative, Rep. Jeff Dunham (R-Turlock). He did not attend.

RELATED: Town Halls Not On The Agenda Of Most Local Congressional Reps

Earlier this month Rep. Tom McClintock (R-Elk Grove) of Northern California was met by angry crowds at a town hall and had to be escorted out by police.

Issas office said he has a prior commitment Tuesday.

Issa spokesman Calvin Moore said district staff have met with coalition members and relayed their concerns to the congressman.

Large numbers of these groups were able to participate our first telephone town hall and ask him questions directly on that call, Moore said. The congressman has written back and responded to their letters and phone calls to our office.

Issa has proposed replacing the Affordable Care Act with access to the health benefit plan that federal employees use. He released a draft of his proposal Tuesday.

In a statement, Issa said he encourages "feedback so that together we can advance a solution that protects patients, and truly puts your needs first. He said he hears every day from constituents who have lost coverage or are worried they will lose it.

"The plan Im proposing frees us from Obamacares burdens, while focusing on what works, to create a simpler, patient-centered, market-based health care alternative that puts patients back in the drivers seat of their health care, he said in a press release.

Issa has supported federal block grants that could leave states or counties responsible for much of the subsidies to make that insurance coverage affordable.

More than 370,000 San Diego county residents are enrolled in health insurance plans under Covered California or the expanded Medi-Cal coverage provided under Obamacare.

RELATED: Medi-Cal Recipients Statewide Would Feel The Pain Of Obamacare Repeal

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Town Hall On Health Care To Go Ahead With Or Without Issa - KPBS

Personalized medicine may do more to treat rather than prevent … – Salon

Posted on February 22, 2017 by Danzig

Personalized medicine, which involves tailoring health care to each persons unique genetic makeup, has the potential to transform how we diagnose, prevent and treat disease. After all, no two people are alike. Mapping a persons unique susceptibility to disease and targeting the right treatment has deservedly been welcomed as a new power to heal.

The human genome, a complete set of human DNA, was identified and mapped a decade ago. But genomic science remains in its infancy. According to Francis Collins, the director of the National Institutes of Health, It is fair to say that the Human Genome Project has not yet directly affected the health care of most individuals.

Its not that there havent been tremendous breakthroughs. Its just that the gap between science and its ability to benefit most patients remains wide. This is mainly because we dont yet fully understand the complex pathways involved in common chronic diseases.

I am part of a research team that has taken on the ambitious goal of narrowing this gap. New technologies are allowing us to probe DNA, RNA, proteins and gut bacteria in a way that will change our understanding of health and disease. Our hope is to discover novel biological markers that can be used to diagnose and treat common chronic conditions, including Alzheimers disease, heart disease, diabetes and cancer.

But when it comes to preventing the leading causes of death which include chronic diseases, genomics and precision medicine may not do as much as we hope.

Many diseases arent due only to genetics

Chronic diseases are only partially heritable. This means that the genes you inherit from your parents arent entirely responsible for your risk of getting most chronic diseases.

The estimated heritability of heart disease is about 50 percent. Its 64 percent for Type 2 diabetes mellitus, and 58 percent for Alzheimers disease. Our environment and lifestyle choice are also major factors; they can change or influence how the information coded in our genes is translated.

Chronic diseases are also complex. Rather than being controlled by a few genes that are easy to find, they are weakly influenced by hundreds if not thousands of genes, the majority of which still elude scientists. Unlocking the infinite combinations in which these genes interact with each other and with the environment is a daunting task that will take decades, if ever, to achieve.

While unraveling the genomic complexity of chronic disease is important, it shouldnt detract from existing simple solutions. Many of our deadliest chronic diseases are preventable. For instance, among U.S. adults, more than 90 percent of Type 2 diabetes, 80 percent of coronary arterial disease, 70 percent of stroke and 70 percent of colon cancer are potentially avoidable.

Smoking, weight gain, lack of exercise, poor diet and alcohol consumption are all risk factors for these conditions. Based on their profound impact on gene expression, or how instructions within a gene are manifested, addressing these factors will likely remain fundamental in preventing these illnesses.

Will more knowledge be more power?

A major premise behind personalized medicine is that empowering patients and doctors with more knowledge will lead to better decision-making. With some major advances, this has indeed been the case. For instance, variants in genes that control an enzyme that metabolizes drugs can identify individuals who metabolize some drugs too rapidly (not giving them a chance to work), or too slowly (leading to toxicity). This can lead to changes in medication dosing.

When applied to prevention, however, identifying our susceptibility at an earlier stage has not aided in avoiding chronic diseases. Research challenges the assumption that we will use genetic markers to change our behavior. More knowledge may nudge intent, but that doesnt translate to motivating changes to our lifestyle.

A recent review found that even when people knew their personal genetic risk of disease, they were no more likely to quit smoking, change their diet or exercise. Expectations that communicating DNA-based risk estimates changes behavior is not supported by existing evidence, the authors conclude.

Increased knowledge may even have the unintended consequence of shifting the focus to personal responsibility while detracting from our joint responsibility for improving public health. Reducing the prevalence of chronic diseases will require changing the political, social and economic environment within which we make choices as well as individual effort.

What about treating chronic diseases?

Perhaps the most awaited hope of the genomic era is that we will be able to develop targeted treatments based on detailed molecular profiling. The implication is that we will be able to subdivide disease into new classifications. Rather than viewing Type 2 diabetes as one disease, for example, we may discover many unique subtypes of diabetes.

This already is happening with some cancers. Patients with melanoma, leukemia or metastatic lung, breast or brain cancers can, in some cases, be offered a molecular diagnosis to tailor their treatment and improve their chance of survival.

We have been able to make progress in cancer therapy and drug safety and efficacy because specific gene mutations control a persons response to these treatments. But for complex, chronic diseases, relatively few personalized targeted treatments exist.

Customizing treatments based on our uniqueness will be a breakthrough, but it also poses a challenge: Without the ability to test targeted treatments on large populations, it will make it infinitely harder to discover and predict their response.

The very reason we group people with the same signs and symptoms into diagnoses is to help predict the average response to treatment. There may be a time when we have one-person trials that custom tailor treatment. However, the anticipation is that the timeline to getting to such trials will be long, the failure rate high and the cost exorbitant.

Research that takes genetic risk of diabetes into account has found greater benefit in targeting prevention efforts to all people with obesity rather than targeting efforts based on genetic risk.

We also have to consider decades of research on chronic diseases that suggest there are inherent limitations to preventing the global prevalence of these diseases with genomic solutions. For most of us, personalized medicine will likely complement rather than replace one-size-fits-all medicine.

Where does that leave us? Despite the inherent limitations to the ability of genomic medicine to transform health care, medicine in the future should unquestionably aspire to be personal. Genomics and molecular biosciences will need to be used holistically in the context of a persons health, beliefs and attitudes to fulfill their power to greatly enhance medicine.

Sharon Horesh Bergquist, Physician, teacher, researcher in preventive medicine and healthy aging, Emory University

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Personalized medicine may do more to treat rather than prevent ... - Salon

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