Sunday, April 6, 2014

jonathan pollard joins Obama in proposing

andrew cuomo for Saint Hood for his good work in seeing that Rome's religious preference is the preference of the State of New York NY Const. Art 1 Sec. 3 notwithstanding

HI-
Thanks for the help. The item’s below. I’d be happy to mail you a copy, if you give me a mailing address.

Claude Solnik
(631) 913-4244
Long Island Business News
2150 Smithtown Ave.
Ronkonkoma, NY 11779-7348 

Home > LI Confidential > Stop scratching on holidays

Stop scratching on holidays
Published: June 1, 2012


Off Track Betting in New York State has been racing into a crisis called shrinking revenue. Some people have spitballed a solution: Don’t close on holidays.
New York State Racing Law bars racing on Christmas, Easter and Palm Sunday, and the state has ruled OTBs can’t handle action on those days, even though they could easily broadcast races from out of state.
“You should be able to bet whenever you want,” said Jackson Leeds, a Nassau OTB employee who makes an occasional bet. He added some irrefutable logic: “How is the business going to make money if you’re not open to take people’s bets?”
Elias Tsekerides, president of the Federation of Hellenic Societies of Greater New York, said OTB is open on Greek Orthodox Easter and Palm Sunday.
“I don’t want discrimination,” Tsekerides said. “They close for the Catholics, but open for the Greek Orthodox? It’s either open for all or not open.”
OTB officials have said they lose millions by closing on Palm Sunday alone, with tracks such as Gulfstream, Santa Anita, Turf Paradise and Hawthorne running.
One option: OTBs could just stay open and face the consequences. New York City OTB did just that back in 2003. The handle was about $1.5 million – and OTB was fined $5,000.
Easy money.

 


Europe News

Obama and Pope Francis Meet in Rome

Pair Sidestep Social Issues, Focus on Economic Inequality

Updated March 27, 2014 3:50 p.m. ET
President Obama and Pope Francis met for the first time at the Vatican on Thursday. Photo: EPA
VATICAN CITY—President Barack Obama and Pope Francis met for the first time on Thursday, holding a symbolic discussion that sidestepped their differences on social issues and focused heavily on their shared interest in economic inequality.
The White House had hoped the highly anticipated visit with the popular pontiff might help draw attention to Mr. Obama's economic agenda. The meeting also took place against a backdrop of divisions between the pope and the president on issues such as gay marriage and contraception.

Photos: Popes and Presidents

President George W. Bush meets with Pope John Paul II at the Vatican on May 28, 2002. Associated Press
Afterward, Mr. Obama said that over the course of 52 minutes in the papal library the two discussed income inequality, immigration overhauls and international conflicts, including in the Middle East, but barely touched on a provision in his health-care law that mandates insurers cover contraception, which the Catholic Church opposes.
"The theme that stitched our conversation together was a belief that in politics and in life, the quality of empathy, the ability to stand in somebody else's shoes and to care for someone even if they don't look like you or talk like you or share your philosophy, that that's critical," Mr. Obama said at a news conference later with Italian Prime Minister Matteo Renzi.
Mr. Obama said he invited Pope Francis to visit the U.S. and told him Americans would be overjoyed to see him.
Thorny issues were covered in Mr. Obama's meeting with the Vatican's secretary of state, Cardinal Pietro Parolin, Mr. Obama said. The cardinal raised concerns about "making sure that conscience and religious freedom was observed in the context of applying the law," Mr. Obama said. "And I explained to him that most religious organizations are entirely exempt," he added.
The Vatican, in a statement after the meeting, made a vague reference to the church's opposition to the contraception mandate, saying Mr. Obama's discussions at the papal residence covered the Americans' ability to exercise "rights to religious freedom, life and conscientious objection."
President Obama had his first meeting with Pope Francis Thursday, a highly anticipated visit the White House hopes will gain support for its economic agenda. Liam Moloney reports. Photo: AP.
In the run-up to the meeting, U.S. bishops had been calling on the pope to express a hard line on those issues. While Pope Francis has called for a reduction of emphasis on such issues by the church's leadership, he has nonetheless strongly reaffirmed church doctrine regarding them.
The Vatican statement following the meeting also said the pair discussed a shared commitment to eradicate human trafficking. The pontiff has been outspoken in urging a peaceful solution to the conflict in Syria, and he will soon travel to the Middle East.
The pope has also drawn some fire, however—particularly in the U.S.—for comments strongly critical of pro-market economic policies. In an interview with an Italian newspaper this month, he said, "it is true that globalization has saved many people from poverty, but it has also condemned many others to death."
Mr. Obama's meeting with Pope Francis was a highlight of a trip through Europe that began Monday. The pontiff is enjoying a level of popularity that far exceeds Mr. Obama's. According to a Gallup poll published Wednesday, 76% of Americans view the pontiff favorably, compared with 52% for Mr. Obama.
Still, American church leaders are hoping that the pope will visit the U.S. in the fall 2015 for a world meeting on families to be held in Philadelphia. House Speaker John Boehner (R., Ohio), who has been at odds with Mr. Obama over his economic agenda, has invited the pope to address a joint session of Congress, and some are hoping the pontiff also will travel to New York to speak to the United Nations.
The Vatican has made no comment on a possible visit and normally confirms papal trips a few months in advance.
While Mr. Obama and Pope Francis' predecessor, Pope Benedict XVI, had a cool relationship, the White House was hoping for better chemistry between the president and the first pope from the developing world. Mr. Obama, who arrived in Italy on Wednesday night, has tried to highlight the similarities in his policy agenda and Pope Francis' strong antipoverty message, even quoting the pontiff in his speech on economic inequality.
President Obama, left, and Pope Francis shake hands during their exchange of gifts Thursday at the Vatican. Associated Press

Pope Replaces 'Bishop of Bling'

Pope Francis accepted the resignation of a senior German cleric dubbed the "Bishop of Bling" for spending $42.7 million on redoing his official residence.
The lift that a nod from Pope Francis could give Mr. Obama's economic proposals wasn't lost on the president, who has struggled to get his agenda through Congress. He told Pope Francis there is still an opportunity to pass immigration overhauls.
The president suggested the pope could play a key, although not political, role in fighting economic inequality.
"There is a potential convergence between what policy makers need to be thinking about and what he's talking about," Mr. Obama said. "He's shining a spotlight on an area that's an increasing concern."
The president arrived at the Vatican Thursday morning, stepping out of a black sport-utility vehicle adorned with American and Vatican City flags into the chilly San Damaso Courtyard at the papal residence. He was greeted by Archbishop Georg Gänswein, the head of the papal residence, and shook hands with a line of Vatican officials before inspecting a cordon of Swiss Guards standing at attention in the courtyard.
"It is a great honor," Mr. Obama said upon meeting the pope, who was seated across from the president at his plain wooden desk. "I'm a great admirer."
At the end of the meeting, when the pair exchanged gifts, Pope Francis gave Mr. Obama a copy of the 224-page manifesto he published in November, in which he urged the church to focus more on the poor while bluntly denouncing inequality and sharply criticizing the market economy.
"I actually will probably read this in the Oval Office when I'm deeply frustrated," Mr. Obama said, smiling. "I'm sure it will give me strength and calm me down."
Mr. Obama gave Pope Francis fruit and vegetable seeds from the White House garden, contained in a box custom made from timber from the Baltimore cathedral, the oldest in the U.S.
"If you have a chance to come to the White House, we can show you our garden as well," he said. The pope responded, in Spanish, "Certainly."
Write to Carol E. Lee at carol.lee@wsj.com and Liam Moloney at liam.moloney@wsj.com



Europe News

Obama and Pope Francis Meet in Rome

Pair Sidestep Social Issues, Focus on Economic Inequality

Updated March 27, 2014 3:50 p.m. ET
President Obama and Pope Francis met for the first time at the Vatican on Thursday. Photo: EPA
VATICAN CITY—President Barack Obama and Pope Francis met for the first time on Thursday, holding a symbolic discussion that sidestepped their differences on social issues and focused heavily on their shared interest in economic inequality.
The White House had hoped the highly anticipated visit with the popular pontiff might help draw attention to Mr. Obama's economic agenda. The meeting also took place against a backdrop of divisions between the pope and the president on issues such as gay marriage and contraception.

Photos: Popes and Presidents

President George W. Bush meets with Pope John Paul II at the Vatican on May 28, 2002. Associated Press
Afterward, Mr. Obama said that over the course of 52 minutes in the papal library the two discussed income inequality, immigration overhauls and international conflicts, including in the Middle East, but barely touched on a provision in his health-care law that mandates insurers cover contraception, which the Catholic Church opposes.
"The theme that stitched our conversation together was a belief that in politics and in life, the quality of empathy, the ability to stand in somebody else's shoes and to care for someone even if they don't look like you or talk like you or share your philosophy, that that's critical," Mr. Obama said at a news conference later with Italian Prime Minister Matteo Renzi.
Mr. Obama said he invited Pope Francis to visit the U.S. and told him Americans would be overjoyed to see him.
Thorny issues were covered in Mr. Obama's meeting with the Vatican's secretary of state, Cardinal Pietro Parolin, Mr. Obama said. The cardinal raised concerns about "making sure that conscience and religious freedom was observed in the context of applying the law," Mr. Obama said. "And I explained to him that most religious organizations are entirely exempt," he added.
The Vatican, in a statement after the meeting, made a vague reference to the church's opposition to the contraception mandate, saying Mr. Obama's discussions at the papal residence covered the Americans' ability to exercise "rights to religious freedom, life and conscientious objection."
President Obama had his first meeting with Pope Francis Thursday, a highly anticipated visit the White House hopes will gain support for its economic agenda. Liam Moloney reports. Photo: AP.
In the run-up to the meeting, U.S. bishops had been calling on the pope to express a hard line on those issues. While Pope Francis has called for a reduction of emphasis on such issues by the church's leadership, he has nonetheless strongly reaffirmed church doctrine regarding them.
The Vatican statement following the meeting also said the pair discussed a shared commitment to eradicate human trafficking. The pontiff has been outspoken in urging a peaceful solution to the conflict in Syria, and he will soon travel to the Middle East.
The pope has also drawn some fire, however—particularly in the U.S.—for comments strongly critical of pro-market economic policies. In an interview with an Italian newspaper this month, he said, "it is true that globalization has saved many people from poverty, but it has also condemned many others to death."
Mr. Obama's meeting with Pope Francis was a highlight of a trip through Europe that began Monday. The pontiff is enjoying a level of popularity that far exceeds Mr. Obama's. According to a Gallup poll published Wednesday, 76% of Americans view the pontiff favorably, compared with 52% for Mr. Obama.
Still, American church leaders are hoping that the pope will visit the U.S. in the fall 2015 for a world meeting on families to be held in Philadelphia. House Speaker John Boehner (R., Ohio), who has been at odds with Mr. Obama over his economic agenda, has invited the pope to address a joint session of Congress, and some are hoping the pontiff also will travel to New York to speak to the United Nations.
The Vatican has made no comment on a possible visit and normally confirms papal trips a few months in advance.
While Mr. Obama and Pope Francis' predecessor, Pope Benedict XVI, had a cool relationship, the White House was hoping for better chemistry between the president and the first pope from the developing world. Mr. Obama, who arrived in Italy on Wednesday night, has tried to highlight the similarities in his policy agenda and Pope Francis' strong antipoverty message, even quoting the pontiff in his speech on economic inequality.
President Obama, left, and Pope Francis shake hands during their exchange of gifts Thursday at the Vatican. Associated Press

Pope Replaces 'Bishop of Bling'

Pope Francis accepted the resignation of a senior German cleric dubbed the "Bishop of Bling" for spending $42.7 million on redoing his official residence.
The lift that a nod from Pope Francis could give Mr. Obama's economic proposals wasn't lost on the president, who has struggled to get his agenda through Congress. He told Pope Francis there is still an opportunity to pass immigration overhauls.
The president suggested the pope could play a key, although not political, role in fighting economic inequality.
"There is a potential convergence between what policy makers need to be thinking about and what he's talking about," Mr. Obama said. "He's shining a spotlight on an area that's an increasing concern."
The president arrived at the Vatican Thursday morning, stepping out of a black sport-utility vehicle adorned with American and Vatican City flags into the chilly San Damaso Courtyard at the papal residence. He was greeted by Archbishop Georg Gänswein, the head of the papal residence, and shook hands with a line of Vatican officials before inspecting a cordon of Swiss Guards standing at attention in the courtyard.
"It is a great honor," Mr. Obama said upon meeting the pope, who was seated across from the president at his plain wooden desk. "I'm a great admirer."
At the end of the meeting, when the pair exchanged gifts, Pope Francis gave Mr. Obama a copy of the 224-page manifesto he published in November, in which he urged the church to focus more on the poor while bluntly denouncing inequality and sharply criticizing the market economy.
"I actually will probably read this in the Oval Office when I'm deeply frustrated," Mr. Obama said, smiling. "I'm sure it will give me strength and calm me down."
Mr. Obama gave Pope Francis fruit and vegetable seeds from the White House garden, contained in a box custom made from timber from the Baltimore cathedral, the oldest in the U.S.
"If you have a chance to come to the White House, we can show you our garden as well," he said. The pope responded, in Spanish, "Certainly."
Write to Carol E. Lee at carol.lee@wsj.com and Liam Moloney at liam.moloney@wsj.com



Europe News

Obama and Pope Francis Meet in Rome

Pair Sidestep Social Issues, Focus on Economic Inequality

Updated March 27, 2014 3:50 p.m. ET
President Obama and Pope Francis met for the first time at the Vatican on Thursday. Photo: EPA
VATICAN CITY—President Barack Obama and Pope Francis met for the first time on Thursday, holding a symbolic discussion that sidestepped their differences on social issues and focused heavily on their shared interest in economic inequality.
The White House had hoped the highly anticipated visit with the popular pontiff might help draw attention to Mr. Obama's economic agenda. The meeting also took place against a backdrop of divisions between the pope and the president on issues such as gay marriage and contraception.

Photos: Popes and Presidents

President George W. Bush meets with Pope John Paul II at the Vatican on May 28, 2002. Associated Press
Afterward, Mr. Obama said that over the course of 52 minutes in the papal library the two discussed income inequality, immigration overhauls and international conflicts, including in the Middle East, but barely touched on a provision in his health-care law that mandates insurers cover contraception, which the Catholic Church opposes.
"The theme that stitched our conversation together was a belief that in politics and in life, the quality of empathy, the ability to stand in somebody else's shoes and to care for someone even if they don't look like you or talk like you or share your philosophy, that that's critical," Mr. Obama said at a news conference later with Italian Prime Minister Matteo Renzi.
Mr. Obama said he invited Pope Francis to visit the U.S. and told him Americans would be overjoyed to see him.
Thorny issues were covered in Mr. Obama's meeting with the Vatican's secretary of state, Cardinal Pietro Parolin, Mr. Obama said. The cardinal raised concerns about "making sure that conscience and religious freedom was observed in the context of applying the law," Mr. Obama said. "And I explained to him that most religious organizations are entirely exempt," he added.
The Vatican, in a statement after the meeting, made a vague reference to the church's opposition to the contraception mandate, saying Mr. Obama's discussions at the papal residence covered the Americans' ability to exercise "rights to religious freedom, life and conscientious objection."
President Obama had his first meeting with Pope Francis Thursday, a highly anticipated visit the White House hopes will gain support for its economic agenda. Liam Moloney reports. Photo: AP.
In the run-up to the meeting, U.S. bishops had been calling on the pope to express a hard line on those issues. While Pope Francis has called for a reduction of emphasis on such issues by the church's leadership, he has nonetheless strongly reaffirmed church doctrine regarding them.
The Vatican statement following the meeting also said the pair discussed a shared commitment to eradicate human trafficking. The pontiff has been outspoken in urging a peaceful solution to the conflict in Syria, and he will soon travel to the Middle East.
The pope has also drawn some fire, however—particularly in the U.S.—for comments strongly critical of pro-market economic policies. In an interview with an Italian newspaper this month, he said, "it is true that globalization has saved many people from poverty, but it has also condemned many others to death."
Mr. Obama's meeting with Pope Francis was a highlight of a trip through Europe that began Monday. The pontiff is enjoying a level of popularity that far exceeds Mr. Obama's. According to a Gallup poll published Wednesday, 76% of Americans view the pontiff favorably, compared with 52% for Mr. Obama.
Still, American church leaders are hoping that the pope will visit the U.S. in the fall 2015 for a world meeting on families to be held in Philadelphia. House Speaker John Boehner (R., Ohio), who has been at odds with Mr. Obama over his economic agenda, has invited the pope to address a joint session of Congress, and some are hoping the pontiff also will travel to New York to speak to the United Nations.
The Vatican has made no comment on a possible visit and normally confirms papal trips a few months in advance.
While Mr. Obama and Pope Francis' predecessor, Pope Benedict XVI, had a cool relationship, the White House was hoping for better chemistry between the president and the first pope from the developing world. Mr. Obama, who arrived in Italy on Wednesday night, has tried to highlight the similarities in his policy agenda and Pope Francis' strong antipoverty message, even quoting the pontiff in his speech on economic inequality.
President Obama, left, and Pope Francis shake hands during their exchange of gifts Thursday at the Vatican. Associated Press

Pope Replaces 'Bishop of Bling'

Pope Francis accepted the resignation of a senior German cleric dubbed the "Bishop of Bling" for spending $42.7 million on redoing his official residence.
The lift that a nod from Pope Francis could give Mr. Obama's economic proposals wasn't lost on the president, who has struggled to get his agenda through Congress. He told Pope Francis there is still an opportunity to pass immigration overhauls.
The president suggested the pope could play a key, although not political, role in fighting economic inequality.
"There is a potential convergence between what policy makers need to be thinking about and what he's talking about," Mr. Obama said. "He's shining a spotlight on an area that's an increasing concern."
The president arrived at the Vatican Thursday morning, stepping out of a black sport-utility vehicle adorned with American and Vatican City flags into the chilly San Damaso Courtyard at the papal residence. He was greeted by Archbishop Georg Gänswein, the head of the papal residence, and shook hands with a line of Vatican officials before inspecting a cordon of Swiss Guards standing at attention in the courtyard.
"It is a great honor," Mr. Obama said upon meeting the pope, who was seated across from the president at his plain wooden desk. "I'm a great admirer."
At the end of the meeting, when the pair exchanged gifts, Pope Francis gave Mr. Obama a copy of the 224-page manifesto he published in November, in which he urged the church to focus more on the poor while bluntly denouncing inequality and sharply criticizing the market economy.
"I actually will probably read this in the Oval Office when I'm deeply frustrated," Mr. Obama said, smiling. "I'm sure it will give me strength and calm me down."
Mr. Obama gave Pope Francis fruit and vegetable seeds from the White House garden, contained in a box custom made from timber from the Baltimore cathedral, the oldest in the U.S.
"If you have a chance to come to the White House, we can show you our garden as well," he said. The pope responded, in Spanish, "Certainly."
Write to Carol E. Lee at carol.lee@wsj.com and Liam Moloney at liam.moloney@wsj.com


Born to kill? There is a better way

Shoot BCG and see what it does as I am trying and am willing to do on TV, You Tube, in print, anytime anywhere.

Denise L Faustman see faustmanlab.org and pubmed.org faustman dl is not god but she is better than any of the crap reported in the New York Times.

Shoot BCG and if you like it you will have plenty of cash left over to do with as you please.

The New York Times and Catherine Hayley are invited to same my blood and observe any changes as BCG is shot again and again

read this Catherine Hayley

Front Immunol. 2013 Dec 23;4:478. eCollection 2013.

TNF Receptor 2 and Disease: Autoimmunity and Regenerative Medicine.

Abstract

THE REGULATORY CYTOKINE TUMOR NECROSIS FACTOR (TNF) EXERTS ITS EFFECTS THROUGH TWO RECEPTORS: TNFR1 and TNFR2. Defects in TNFR2 signaling are evident in a variety of autoimmune diseases. One new treatment strategy for autoimmune disease is selective destruction of autoreactive T cells by administration of TNF, TNF inducers, or TNFR2 agonism. A related strategy is to rely on TNFR2 agonism to induce T-regulatory cells (Tregs) that suppress cytotoxic T cells. Targeting TNFR2 as a treatment strategy is likely superior to TNFR1 because of its more limited cellular distribution on T cells, subsets of neurons, and a few other cell types, whereas TNFR1 is expressed throughout the body. This review focuses on TNFR2 expression, structure, and signaling; TNFR2 signaling in autoimmune disease; treatment strategies targeting TNFR2 in autoimmunity; and the potential for TNFR2 to facilitate end organ regeneration.

KEYWORDS:

TNF, TNF receptor 2, autoimmune disease, regeneration, type 1 diabetes




    1. Maureen Dowd

How many relatives of Catherine Hayley have autoimmune diseases and what diseases are they?
I would like to compare my answers with hers?

PLoS One. 2012;7(8):e41756. doi: 10.1371/journal.pone.0041756. Epub 2012 Aug 8.

Proof-of-concept, randomized, controlled clinical trial of Bacillus-Calmette-Guerin for treatment of long-term type 1 diabetes.

Abstract

BACKGROUND:

No targeted immunotherapies reverse type 1 diabetes in humans. However, in a rodent model of type 1 diabetes, Bacillus Calmette-Guerin (BCG) reverses disease by restoring insulin secretion. Specifically, it stimulates innate immunity by inducing the host to produce tumor necrosis factor (TNF), which, in turn, kills disease-causing autoimmune cells and restores pancreatic beta-cell function through regeneration.

METHODOLOGY/PRINCIPAL FINDINGS:

Translating these findings to humans, we administered BCG, a generic vaccine, in a proof-of-principle, double-blind, placebo-controlled trial of adults with long-term type 1 diabetes (mean: 15.3 years) at one clinical center in North America. Six subjects were randomly assigned to BCG or placebo and compared to self, healthy paired controls (n = 6) or reference subjects with (n = 57) or without (n = 16) type 1 diabetes, depending upon the outcome measure. We monitored weekly blood samples for 20 weeks for insulin-autoreactive T cells, regulatory T cells (Tregs), glutamic acid decarboxylase (GAD) and other autoantibodies, and C-peptide, a marker of insulin secretion. BCG-treated patients and one placebo-treated patient who, after enrollment, unexpectedly developed acute Epstein-Barr virus infection, a known TNF inducer, exclusively showed increases in dead insulin-autoreactive T cells and induction of Tregs. C-peptide levels (pmol/L) significantly rose transiently in two BCG-treated subjects (means: 3.49 pmol/L [95% CI 2.95-3.8], 2.57 [95% CI 1.65-3.49]) and the EBV-infected subject (3.16 [95% CI 2.54-3.69]) vs.1.65 [95% CI 1.55-3.2] in reference diabetic subjects. BCG-treated subjects each had more than 50% of their C-peptide values above the 95(th) percentile of the reference subjects. The EBV-infected subject had 18% of C-peptide values above this level.

CONCLUSIONS/SIGNIFICANCE:

We conclude that BCG treatment or EBV infection transiently modified the autoimmunity that underlies type 1 diabetes by stimulating the host innate immune response. This suggests that BCG or other stimulators of host innate immunity may have value in the treatment of long-term diabetes.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00607230.



Photo

"It’s the most expensive thing I own, aside from my house." CATHERINE HAYLEY, whose diabetes was diagnosed when she was 9, describing the digital insulin pump that helps keep her alive. Credit Luke Sharrett for The New York Times
Continue reading the main story Share This Page
Continue reading the main story
MEMPHIS — Catherine Hayley is saving up for an important purchase: an updated version of the tiny digital pump at her waist that delivers lifesaving insulin under her skin.
Such devices, which tailor insulin dosing more precisely to the body’s needs, have transformed the lives of people with Type 1 diabetes like Ms. Hayley. But as diabetics live longer, healthier lives and worries fade about dreaded complications like heart attacks, kidney failure, amputations and blindness, they have been replaced by another preoccupation: soaring treatment costs.
“It looks like a beeper,” said Ms. Hayley, a 36-year-old manager here for an environmental services company, referring to the vintage 2007 pump on the waistband of her jeans. “It’s made of plastic and runs on triple-A batteries, but it’s the most expensive thing I own, aside from my house.”
A new model, along with related treatment supplies, prices out at tens of thousands of dollars for this year and will cost her about $5,000, even with top-notch insurance. “It’s great,” Ms. Hayley said, “but it all adds up.”
Continue reading the main story
Continue reading the main story

Readers’ Perspectives
As you read this article, please share your experiences by responding to the questions that will appear. Your responses will inspire future articles in this series.

Traditionally, insurers lost money by covering people with chronic illnesses, because they often ended up hospitalized with myriad complications as their diseases progressed. Today, the routine care costs of many chronic illnesses eclipse that of acute care because new treatments that keep patients well have become a multibillion-dollar business opportunity for device and drug makers and medical providers.
The high price of new treatments for diabetes, rheumatoid arthritis, colitis and other chronic diseases contribute mightily to the United States’ $2.7 trillion annual health care bill.
More than 1.5 million Americans have Type 1 diabetes and cannot survive without frequent insulin doses, so they are utterly dependent on a small number of producers of supplies and drugs, which have great leeway to set prices. (Patients with the far more common Type 2 diabetes — linked to obesity — still produce insulin and can improve with lifestyle changes and weight loss, or on oral medicines.)
That captive audience of Type 1 diabetics has spawned lines of high-priced gadgets and disposable accouterments, borrowing business models from technology companies like Apple: Each pump and monitor requires the separate purchase of an array of items that are often brand and model specific.
A steady stream of new models and updates often offer dubious improvement: colored pumps; talking, bilingual meters; sensors reporting minute-by-minute sugar readouts. Ms. Hayley’s new pump will cost $7,350 (she will pay $2,500 under the terms of her insurance). But she will also need to pay her part for supplies, including $100 monitor probes that must be replaced every week, disposable tubing that she must change every three days and 10 or so test strips every day.
That does not even include insulin, which has been produced with genetic engineering and protected by patents, so that a medicine that cost a few dollars when Ms. Hayley was a child now often sells for more than $200 a vial, meaning some patients must pay more than $4,000 a year. Other refinements have benefited a minority of patients but raised prices for all. There are no generics in the United States.
Continue reading the main story

The Cost to Treat One Woman’s Diabetes in 2014


Delivering Insulin
Catherine Hayley’s cost
$4,224
Insulin
Insulin pump
reservoir
Cost with no insurance
AAA
battery
$26,470
Insulin pump
infusion set
Testing Blood Sugar
Lancets
Insulin pump
Costs Ms. Hayley $2,500. Her insurance
allows her to upgrade every four years.
In Case of
Emergency
Emergency
glucagon kit
Test strips
Because she has not yet made some of the 2014 purchases, the old version of the pump is shown here and the total cost does not include an additional transmitter and disposable sensors.
Companies that produce the treatments say the higher costs reflect medical advances and the need to recoup money spent on research. But David Kliff, a financial analyst who is editor of Diabetic Investor, an independent newsletter on the industry, points out: “Diabetes is not just a disease state; it’s a huge business, too.”
Those companies spend millions of dollars recruiting patients at health fairs, through physicians’ offices and with aggressive advertising — often urging them to get devices and treatments that are not necessary, doctors say. “They may be better in some abstract sense, but the clinical relevance is minor,” said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center.
“People don’t need a meter that talks to them,” he added. “There’s an incredible waste of money.”
Photo

"People don’t need a meter that talks to them. There’s an incredible waste of money." DR. JOEL ZONSZEIN, director of the Clinical Diabetes Center at Montefiore Medical Center. Credit Karsten Moran for The New York Times
Even patients with insurance often feel squeezed by large out-of-pocket costs, and many describe holding old pumps together with duct tape, rationing their test strips and skimping on insulin. Dr. Jeoffry B. Gordon, a family practitioner in San Diego, said he had patients with failing kidneys and others who had ended up in emergency rooms because they could not afford their maintenance care.
“From a guy on the front lines, the improvements have been miraculous,” he said. “But the acquisition cost is very high, and the pricing dictates what treatment you get.”
Complication rates from diabetes in the United States are generally higher than in other developed countries. That is true even though the United States spends more per patient and per capita treating diabetes than elsewhere, said Ping Zhang, an economist at the Centers for Disease Control and Prevention.
The high costs are taking their toll on public coffers, since 62 percent of that treatment money comes from government insurers. The cumulative outlays for treating Type 1 and Type 2 diabetes reached nearly $200 billion in 2012, or about 7 percent of America’s health care bill.
Expenditures could well double by 2030, according to estimates by the C.D.C., in large part because the number of Americans found to have diabetes has been increasing more than 50 percent every 10 years. Most of the increase is attributable to Type 2 diabetes patients, whom manufacturers are encouraging to try insulin treatment and glucose monitoring, even though that is rarely medically required. Also, the Affordable Care Act requires health insurers to cover people with chronic disease, meaning they will have better access to treatments.
“This is not just a health care crisis,” said Mr. Kliff, the newsletter editor, who has Type 1 diabetes. “It’s an economic crisis as well.”
Maintaining Control
Catherine Hayley was born in 1977, the year before the first synthetic human insulin was made using new gene-splicing technology. Her diabetes was diagnosed when she was 9, about the time this new generation of genetically engineered insulin was brought to market. One of her earliest memories is practicing insulin injections on an orange.
The development of insulin therapy in the 1920s was one of the great medical triumphs of the 20th century, on a par with the discovery of antibiotics. Before then, Type 1 diabetics often died within a year and were on such restrictive diets that they sometimes succumbed to starvation.
Diabetes is an autoimmune disease in which the pancreas stops producing the hormone insulin. Without it, sugars build up in the blood, producing symptoms like blurry vision, exhaustion and frequent urination and leading to a severe accumulation of acids that can be rapidly fatal. Even when treated with insulin shots, moderately high sugar levels over the long term can damage the eyes, heart, kidneys and nerves. But if too much insulin is given, blood sugar can plummet, leading to unconsciousness and seizures. Because digestive enzymes degrade insulin, it cannot be swallowed, and must be injected.
Photo

THE BUSINESS OF ILLNESS The American Diabetes Association’s recent exposition in New York attracted all manner of vendors. Pictured: An appearance by an Ironman facsimile against an insurer’s backdrop. Credit Christopher Gregory for The New York Times
When Ms. Hayley’s diabetes was diagnosed, maintaining that balance involved testing a drop of blood on a paper strip that would change color to indicate — within a wide range — the patient’s glucose level. Patients would typically give themselves a shot of insulin morning and night in response to the results.
“What I ate was all very regimented, and it had to be at the same time each day,” she recalled. At school every day at 10 a.m., she pulled out a snack of a precisely weighed chunk of cheese and rice cakes.
The treatment tools were initially cheap: simple syringes and pig insulin, which is almost identical to that made by the human body. But that all changed after a landmark study in 1992 showed that patients did better if they maintained very tight control — keeping their blood sugar within a nearly normal range by checking it frequently and taking multiple insulin shots a day. Around the same time the business of American medicine was changing, too, with direct-to-consumer advertising, proprietary treatments and designer insulin in development.
When Ms. Hayley left Memphis for Colorado College in 1996, she was using a tiny meter through which she could get more precise measures of her blood sugar level, a penlike injector containing insulin with an adjustable dose, and human insulin made with gene-splicing technology. All were covered by patents.
Photo

A saleswoman for Medtronic demonstrating one of the company’s insulin pumps. Credit Christopher Gregory for The New York Times
She did not switch to a pump until 2006 when, after years of waiting tables and studying in graduate school, she got her first job with insurance benefits. “It controls my blood sugar better,” she said, on her way to a dinner that included sharing a once-forbidden fruit cobbler. “I’m really able to live how I want. However, the price has increased dramatically.”
The tiny squirts from her pump are delivered more precisely by patented systems with microchip sensors and Bluetooth capability, with technical support by company representatives in endocrinologists’ offices. When Ms. Hayley pricks her finger, it is with a customized lancet to go with a customized test strip that fits into a customized meter, which transmits the result wirelessly to her compatible insulin pump, which delivers the appropriate insulin dose. (There is not yet a one-device-does-all that automatically performs the pricking, measuring and dosing.)
While some components, like the meters, are low cost or even free for patients, their supplies are costly. Dr. Spencer Owades, a dentist in suburban Denver with Type 1 diabetes, said he was shocked to discover that his test strips — which cost just pennies to make — were priced at $1.50 apiece when he ran out and had to buy them at a pharmacy. He usually received them in the mail through his insurer and uses five to 10 a day.
“It’s a printer model,” he said, “where the printer is cheap, but they get you on the cartridges.” He added: “But if you have diabetes, they have you over a barrel.”

Putin comes to Franklin Square Branch of

Nassau OTB with force of arms and nuclear weapons to liberate Crimean Bettors from the tyranny of Andrew Cuomo who excludes people from betting while he is in church.   Russian Orthodox Church seeks lawyers to see that NY Const. Art. 1, Sec. 3 is enforced in NY in 2014


Nassau OTB must be open 365 days of the year whether Andrew Cuomo is in church or in the latrine.



Searchable keywords
  • off-track
31 bills matched your search criteria:
  • A00867Authorizes gambling on professional sporting events and athletic events sponsored by universities or colleges
  • A01899Authorizes the division of the lottery to conduct the operation of video lottery wagering at the regional off-track betting facilities
  • A02329Authorizes racetracks and off-track betting corporations to offer rebates on pari-mutuel wagers made by bettors and to horse racing patrons
  • A02836Provides for funding for a sound basic education
  • A03006Amends various provisions of law relating to implementing the health and mental hygiene budget for the 2013-2014 state fiscal year
  • A03333Provides for payments to licensed harness tracks by regional off-track betting corporations
  • A03717Relates to the members of the franchise oversight board and the duties and responsibilities of such board
  • A03939Repeals certain provisions relating to dark day commission payments made to licensed regional harness tracks from off-track betting corporations
  • A03979Establishes antitrust exemptions for certain horse racing agreements
  • A03995Directs the state to reimburse the city of New York for the health care benefits of the retirees of the New York city off-track betting corporation; appropriation
  • A04091Relates to the members of the franchise oversight board and the duties and responsibilities of such board
  • A04235Authorizes the state gaming commission to impose fines upon entities participating in thoroughbred race meetings or off-track wagering; non-patrons
  • A04236Extends the Catskill region to include the five counties comprising the city of New York; repealer
  • A04497Establishes antitrust exemptions for certain horse racing agreements
  • A05963Authorizes off-track betting corporations to host video lottery terminals
  • A06562Authorizes Nassau and Suffolk regional off-track betting corporations to host video lottery terminals
  • A07256Authorizes grants for the New York city off-track betting corporation
  • A07594Includes the city of Syracuse in the capital district off track betting region
  • A08055Amends the provisions of law providing medical assistance to retirees of the New York city off-track betting corporation and their dependents, to eliminate cost recovery thereof
  • S00331Authorizes gambling on professional sporting events and athletic events sponsored by universities or colleges
  • S01279Provides for payments to licensed harness tracks by regional off-track betting corporations
  • S02433Authorizes racetracks and off-track betting corporations to offer rebates on pari-mutuel wagers made by bettors and to horse racing patrons
  • S02606Enacts into law major components of legislation necessary to implement the state health mental hygiene budget for the 2013-2014 state fiscal year
  • S02982Relates to the disposition of off-track pools
  • S02988Relates to the members of the franchise oversight board and the duties and responsibilities of such board
  • S03026Establishes antitrust exemptions for certain horse racing agreements
  • S03706Directs the state to reimburse the city of New York for the health care benefits of the retirees of the New York city off-track betting corporation; appropriation
  • S04989Authorizes off-track betting corporations to host video lottery terminals
  • S05200Includes the city of Syracuse in the capital district off track betting region
  • S05705Extends the Catskill region to include the five counties comprising the city of New York; repealer
  • S05814Amends the provisions of law providing medical assistance to retirees of the New York city off-track betting corporation and their dependents, to eliminate cost recovery thereof