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Proposals May Limit Insurance Choices And Squeeze Some Middle Earners
"President Obama and leading Democrats have stressed that people who like their employer-sponsored insurance would be able to keep it, under a health care overhaul. But they haven"t emphasized the flip side: That people who don"t like their coverage might have to keep it," Kaiser Health News reports. "Under the main health bills being debated in Congress, many people with job-based insurance could find it difficult to impossible to switch to health plans on a new insurance exchange, even if the plans there were cheaper or offered better coverage. The restrictions extend to any government-run plan, which would be offered on the exchange." But "there are a few exceptions: Workers would be allowed to buy insurance through the exchange if their job-based coverage gobbled up too much of their incomes or was too skimpy. Also, under the House proposal, people could get insurance through the exchange if they paid their entire premiums - a cost that would be prohibitive for many workers."

Total Knee Replacement Appears Cost-Effective In Older Adults
Total knee replacement (arthroplasty) appears to be a cost-effective procedure for older adults with advanced osteoarthritis, according to a report in the June 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. The procedure appears to be cost-effective across all patient risk groups, and appeared more costly and less effective in low-volume centers than in high-volume centers.
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White House, Congress, Industry Taking On Health Costs
Health care costs soared nearly 50 percent between 2000 and 2006, adding an urgency for reform that may help Democrats pass a major overhaul before the year-end deadline set by the White House, Bloomberg reports. "You come to a point where you can"t afford health care as it is and you have to reform it," Rep. John Dingell, D-Mich., told Bloomberg. As Congress seeks to capitalize on spending growth, industry groups have arrived at the table with their own suggestions for cutting up to $1.7 trillion in spending over the upcoming decade (Litvan, 6/2).
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Researchers Say Stress In The Womb Can Last A Lifetime

Visitors can see how their stress levels could affect the heart rate of their unborn baby and find out why pregnant women should reduce their anxiety, at a new exhibit at the Royal Society Summer Science Exhibition, which opens today (30 June 2009). The researchers behind the exhibit, from Imperial College London, hope that it will raise families" awareness of the importance of reducing levels of stress and anxiety in expectant mothers. They say that reducing stress during pregnancy could help prevent thousands of children from developing emotional and behavioural problems. Visitors to the Exhibition will have the chance to play a game that shows how a mother"s stress can increase the heart rate of her unborn baby. They will also be able to touch a real placenta, encased safely in plastic. The placenta is crucial for fetal development and it usually protects the unborn baby from the stress hormone cortisol. However, when the mother is stressed, the placenta becomes less protective and the mother"s cortisol may have an effect on the fetus. The Imperial researchers" work has shown that maternal stress and anxiety can alter the development of the baby"s brain. This in turn can result in a greater risk of emotional problems such as anxiety or depression, behavioural problems such as Attention Deficit Hyperactivity Disorder, and being considerably slower at learning. Some studies have even suggested that it may increase the likelihood of later violent or criminal behaviour. Their findings have suggested that the effects of stress during pregnancy can last many years, including into adolescence. Professor Vivette Glover, the lead researcher behind the exhibit from the Institute of Reproductive and Developmental Biology at Imperial College London, said: "We all know that if a mother smokes or drinks a lot of alcohol while pregnant it can affect her fetus. Our work has shown that other more subtle factors, such as her emotional state, can also have long-term effects on her child. We hope our exhibit will demonstrate in a fun way why we all need to look after expectant mothers" emotional wellbeing. "Our research shows that stress due to the mother"s relationship with her partner can be particularly damaging. We want fathers visiting our exhibit to see how they can help with the development of their child even before the birth, by helping their partner to stay happy," added Professor Glover. The researchers say that the stress hormone cortisol may be one way in which the fetus is affected by the mother"s anxiety during pregnancy. Usually the placenta protects the unborn baby from the mother"s cortisol, by producing an enzyme that breaks the hormone down. When the mother is very stressed, this enzyme works less well and lets her cortisol through the placenta. By studying the amount of cortisol in the amniotic fluid, the Imperial researchers" latest study suggests that the higher the level of cortisol in the womb, the lower the toddler"s cognitive development or "baby IQ" at 18 months. Kieran O"Donnell from the Institute of Reproductive and Developmental Biology at Imperial College London said: "We are very excited to have this opportunity to talk with the public about our work. We think that by promoting awareness of this subject we may be able to benefit many families in the future." The scientists will be on hand at the exhibition, which runs from 30 June to 4 July. Lucy Goodchild Imperial College London


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