Supreme Court weighs in on the Affordable Care Act
Hands down, the biggest health story of year was the June 28 ruling by the Supreme Court upholding the Affordable Care Act. The background: President Obama signed the bill in 2010 but conservatives detest it and challenged a provision in the law, called the "individual mandate," that requires everyone to buy health insurance or pay a fine. The individual mandate is the core of the law, and if the court struck it down, the whole Obamacare package would have likely collapsed. However, on a five-four vote, the court ruled that the individual mandate was constitutional, citing Congress's power to levy taxes.
Among the many facets of the Affordable Care Act, the law allows young adults to stay on their parents' insurance policies until age 26, expands the access to free preventive care and screenings, and forbids insurance companies from refusing to cover or charging excessive premiums for people with pre-existing medical conditions. It also forbids insurance companies from placing a lifetime limit on coverage, expands access to Medicaid and establishes insurance exchanges in states to allow people to buy individual insurance policies.
The ruling had a bigger influence on the future shape of healthcare than Obama's reelection because, even if Obama had lost, it would have been nearly impossible to repeal the law, as Republican presidential candidate Mitt Romney said he would do. Of course, Obama's reelection means full steam ahead on healthcare reform. It's here to stay, folks.
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Two states vote to legalize marijuana
After many years of debate over the legalization of marijuana, the wisdom of legalization will soon be put to the test. Two states—Colorado and Washington—passed laws in November to legalize the sale of small amounts of marijuana for personal use.
Critics of legalization say the laws will create more addicts, that marijuana is a gateway drug that will cause more kids to use and then advance to more dangerous illicit drugs. They say legalization poses public health risks, such as in increase in the number of impaired drivers. Proponents of legalization say marijuana is no more harmful than alcohol, that the "war on drugs" has failed, and that the courts and prisons are overburdened with people charged with minor drug crimes.
The first HIV prevention drug is approved
The Food and Drug Administration in July approved the first drug to help prevent HIV infection from sexual contact—the first such HIV prevention medication. The drug is taken daily and, in combination with safe-sex practices, appears to substantially reduce the risk of infection. Truvada is not a new drug. The FDA previously approved it for use with other HIV drugs to treat HIV infection.
The approval "marks an important milestone in our fight against HIV," said FDA Commissioner Margaret A. Hamburg. "Every year, about 50,000 U.S. adults and adolescents are diagnosed with HIV infection, despite the availability of prevention methods and strategies to educate, test, and care for people living with the disease. New treatments as well as prevention methods are needed to fight the HIV epidemic in this country."
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Obesity rates in kids beginning to drop
We saw the first hint of progress in the battle against obesity a few years ago when the rates of obesity among kids stopped rising and appeared to stabilize. Now, however, several new studies confirm that rates are dropping in many corners of the nation. A study released this month from the Robert Wood Johnson Foundation showed decreases in child obesity have been seen in New York City, Philadelphia and parts of California and Mississippi. Between 2006 and 2011, the obesity rate among schoolchildren fell by about five percent in New York City and Philadelphia.
The progress comes in regions that have made a concerted effort to address obesity. Both New York and California have menu labeling laws, for example. New York City now requires daycare centers to offer physical activity. In Philadelphia, sodas were banned from school vending machines many years ago. Studies show that one-third of U.S. children are overweight and 17 percent are obese.
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Court strikes down graphic cigarette warning labels
The U.S. Court of Appeals for the District of Columbia Circuit voted two to one in August to strike down a law requiring large, graphic warning labels be placed on cigarette packages—a decision that has dealt a blow to the anti-tobacco campaign. Many countries allow graphic warning labels—such as a photo of someone dying of lung cancer—on cigarette packages, and U.S. public health authorities were hoping to join that trend. Right now, only a written warning message appears on tobacco products.
Tobacco companies contend that graphic images violate the First Amendment's free-speech clause. The court sided with that point of view, also stating that the federal government had failed to show that the addition of graphic images would reduce smoking rates—even though studies have shown that the pictorial warning labels are effective in reducing smoking. It's not yet clear how the FDA, which has authority over tobacco products, will respond to the ruling.
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Pertussis rates hit record levels in the vaccination era
A vaccine to prevent pertussis, also known as whooping cough, has been around for decades. Nevertheless, the virus is making a vicious comeback, with rates this year reaching the highest levels in five decades.
Several factors are to blame. One is that more parents today are refusing to have their children vaccinated, which leads to a large group of vulnerable people. But this year medical experts have also released studies showing that the vaccine, which was reformulated in the late 1990s to be safer, may not be as effective as first thought. The booster shot that children receive around age 11 appears to offer a much shorter period of protection. Discussions are now underway to address the flaws in the pertussis vaccination program. Health officials may recommend more frequent booster shots or may look for a better vaccine.
Whooping cough is most dangerous for infants. This year federal health authorities also urged all pregnant women to receive a pertussis booster shot in order to protect their infants from the disease.
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Boomers should get hepatitis C test
The federal government issued a recommendation in May advising all Baby Boomers to get tested for hepatitis C. According to the Centers for Disease Control and Prevention, the nation is facing a huge wave of liver-related illnesses in the coming years. An estimated two million adults—one in every 30 boomers—have hepatitis C, but the virus is often silent for many years, and people don't know they're infected until they experience severe health problems.
People born from 1945 to 1965 have higher rates of the virus than other age groups. In many cases, people were exposed decades ago from using injected drugs. By getting tested now, an estimated 800,000 people will find out they carry the virus and can get medical treatment to prevent cancer, liver cirrhosis and other complications.
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Two obesity medications hit the market
The first new prescription obesity medication in 13 years was approved by the FDA in June. And, only weeks later, a second drug was approved as well. The medications are much-needed options for people who battle obesity and have failed to lose weight, or sustain a weight loss, using diet and exercise.
Over the past few years, several pharmaceutical companies have sought FDA approval for weight-loss drugs only to be met with skepticism or concerns from FDA advisory committees or the FDA itself. The first new medication, lorcaserin, which will be sold under the brand name Belviq, was originally denied approval by the FDA due to concerns that it might cause heart problems.
The second drug to be approved is called Qsymia, but was formerly called Qnexa. It, too, was originally turned down by the FDA due to concerns about the drug's impact on the heart. However, patients and doctors who treat obesity had loudly protested FDA's reluctance and ultimately succeeded in convincing the agency that some risks associated with medication treatment are acceptable given the range of health problems caused by obesity.
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Planned Parenthood battles attacks
This was a tough year for Planned Parenthood. The organization, one of the largest providers of women's health services in the country, was rattled in January when officials at the Susan G. Komen Foundation said they would stop providing funds to Planned Parenthood clinics for breast-health services. The move was largely viewed as a veiled attempt by Komen to dissociate itself from an abortion provider. But a public outcry led to a quick reversal of the decision, the resignation of a top Komen executive and, later in the year, the resignation of founder Nancy Brinker as chief executive of the Komen Foundation.
Planned Parenthood's woes continued this year, however. The organization has fought attempts of Republicans in Congress to strip it of federal funds for non-abortion-related health services. Several states, including North Carolina, are seeking to halt public funding to Planned Parenthood.
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Progress on a vaccine to protect against HIV
Following FDA approval, Canadian researchers began the first human clinical trial to test an experimental vaccine to cure HIV. The vaccine, called SAV001, is being tested in a phase I trial, which is a study to simply assess safety. But it's still a monumental step forward after three decades of the disease. HIV can be treated but cannot be cured by existing therapies.
The vaccine uses killed whole HIV-1 in a method that is similar to the way vaccines for polio or flu work—by stimulating a strong immune response against the real virus. The HIV-1 contained in the vaccine is genetically engineered, so it's safe and can be made in large quantities.