Obama Defends Healthcare Law, But Says He's Open To Reasonable Changes
While President Barack Obama admitted yesterday that he was disappointed in Tuesday's election results in which the Republicans regained control of the House of Representatives, he vigorously defended the sweeping healthcare overhaul passed earlier this year, insisting that it was "the right thing to do." At a White House press conference, he stated, "I don't think that if you ask the American people, should we stop trying to close the doughnut hole that will help senior citizens get prescription drugs, should we go back to a situation where people with preexisting conditions can't get health insurance, should we allow insurance companies to drop your coverage when you get sick even though you've been paying premiums—I don't think that you'd have a strong vote for people saying those are provisions I want to eliminate." Exit poll data suggests that one in two voters wants to repeal the law, and Obama said he's open to tweaks, according to Kaiser Health News. "If the Republicans have ideas for how to improve our health care system, if they want to suggest modifications that would deliver faster and more effective reform…I'm happy to consider some of those ideas," he said.
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Home Blood Pressure Monitoring Works Better Than Doctor's
Family physicians often have a tough time monitoring chronic health conditions, which leads to poor management of those conditions, family physician Kenny Lin writes for U.S. News. Only half of the 65 million Americans with hypertension have achieved good control, according to a recent commentary in the American Journal of Managed Care. And it's not hard to understand why: A patient's blood pressure at an office visit may not be an accurate reflection of what the reading typically is at home; in fact, it's often much higher, leading doctors to coin the term "white coat hypertension." Knowing this, doctors are often reluctant to increase medication doses or add new medications; we're afraid of lowering blood pressure too much, which can make patients lightheaded and cause them to stop taking their medications altogether.
Given this unacceptable situation, family doctors need to adopt a new model of care that includes more frequent contacts with patients and adjustment of medications based on blood pressure monitoring at home, stress the authors of the AJMC paper who are affiliated with the University of California at San Francisco Medical Center. They suggest that hypertensive patients receive home monitors to check their blood pressure on a daily basis and record the readings in a paper or electronic log. Nurses, medical assistants, or other "health coaches" should call patients every two weeks in between office visits to check on their blood pressure readings and provide counseling on lifestyle changes, such as starting an exercise program or reducing dietary sodium. If a patient's home blood pressure readings are too high, a medication dose can be increased using standard protocols that are pre-approved by the doctor. This model is supported by research: A 2008 study published in the Journal of the American Medical Association found that patients who received home blood pressure monitors and regular contacts from a pharmacist through a secure Web site were significantly more likely to achieve blood pressure control after one year compared to patients who weren't monitoring themselves. [Read more: Home Blood Pressure Monitoring Works Better Than Doctor's.]
Former 'Bad' Kid Dishes on How to Deal With Problem Children
There are lots of parenting guides on how to deal with defiant children, but this is probably the only one written by a former defiant child. Joe Newman knows all about the kids that drive parents bonkers. After being diagnosed with attention deficit hyperactivity disorder and being put on Ritalin in second grade, he went on to achieve success in business before deciding to make a career out of helping problem kids. He has spent the past 20 years working with teachers, parents, and children on managing behavior problems. His new book, Raising Lions (CreateSpace, $18.99), explains why children today are fiercer than they used to be. U.S. News contributor Nancy Shute spoke with Newman; here's an edited version of the conversation:
Q: Why did you decide to start working with "not polite" children?
A: When I was in my late 20s I did some soul-searching. I realized in the years since high school a lot of what I had been doing was damage control for what I had done in school. I thought, "There must be a lot of kids out there like me." I just walked into an elementary school and said I wanted to volunteer: "I want to work with the kids who drive you crazy." They were ecstatic. Six months later, I applied to work at a summer camp where it was all ADD kids. I told the owner about my experience, and how you have to start from understanding their capacities and gifts, since that's the only place you could build from. He hired me as their crisis intervention person. I learned by doing over the years, watching people who were better than I was. [Read more: Former 'Bad' Kid Dishes on How to Deal With Problem Children.]
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