Daily Rounds: Young Adults Boost Health Coverage: Psychiatry In Rural India; MS Pill Approved; Regulating Circumcision

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Census’ 2011 Poverty, Income, and Health Insurance Data: Gains In Health Insurance Coverage (The Center For Budget and Policy Priorities) — "The main positive news in today’s report is the fall in the share of Americans who are uninsured, from 16.3 percent in 2010 to 15.7 percent in 2011, the largest annual improvement since 1999. That improvement was driven in part by gains in coverage among young adults, which appear largely due to a provision of the health reform law allowing them to remain on their parent’s health plan until they reach age 26. Forty percent of the decline in the number of uninsured people came among individuals aged 19-25. Some 539,000 fewer 19-25-year-olds were uninsured in 2011 than in 2010."

Reimagining Psychiatry In Rural India (The Atlantic) — "A lime green RV parked in the dirt lot directly in front of the neighboring temple; inside, Sathya was able to Skype with a psychiatrist over 240 miles away in urban Chennai. The doctor diagnosed her with schizophrenia and prescribed psychiatric medication that Sathya collected for free from a window in the back of the bus. The RV was a mobile telepsychiatry clinic, a project of the Chennai-based nonprofit Schizophrenia Research Foundation (SCARF). SCARF now reaches 800 villages like Sathya's through telepsychiatry, connecting hard-to-reach patients with psychiatrists and prescriptions. It's an oft-cited statistic in the discussion on mental health in India: it is estimated there is only one licensed psychiatrist for every 400,000 people. (The United States has roughly 58 per 400,000, in comparison, and Argentina leads the world with an estimated 580.) And with many of the nation's psychiatrists in cities, the numbers are even lower in rural areas. But Indian mental health advocates say simply training more psychiatrists isn't the answer. As researcher and psychiatrist Dr. Vikram Patel, founder of mental health NGO Sangath, wrote: Mental health services in developing nations imitate those in the West, where specialists in clinics or hospitals treat patients. This works well when there are enough specialists, and importantly, enough hospitals. When both are in short supply, more innovative thinking is needed."

FDA Approves Genzyme Corp's Pill For Treating Multiple Sclerosis (The Boston Globe) — "The positive ruling for the Cambridge biotechnology company’s therapy, called Aubagio, marks the Food and Drug Administration’s first approval of a Genzyme drug since French pharmaceutical giant Sanofi SA bought Genzyme for $20.1 billion in 2010. Under its new corporate parent, Genzyme, long known as a maker of treatments for rare diseases, has mounted an effort to enter the lucrative, and broader, market for multiple sclerosis drugs, which is estimated at about $13 billion a year worldwide. Most multiple sclerosis drugs now available are given to patients through injections. The autoimmune disease affects the brain and central nervous system of about 400,000 Americans and 2.5 million people globally. Among the treatments are Avonex, made by Weston-based Biogen Idec Inc., and Rebif, manufactured by German-owned EMD Serono of Rockland. Aubagio “offers patients an opportunity to remove themselves from the burden of daily or weekly injections,” said Bill Sibold, head of Genzyme’s multiple sclerosis business."

Panel Weighs Regulating Circumcision, Dividing Jews (The New York Times) — "The city estimates that metzitzah b’peh is used in some 3,600 local circumcisions each year. The city’s health department says that, between 2000 and 2011, 11 babies contracted herpes as a result, and 2 of them died. This spring, the Centers for Disease Control and Prevention declared that the procedure created a risk for transmission of herpes and other pathogens and was “not safe.” So on Thursday, the city’s Board of Health is scheduled to vote on a proposal that would require parents to sign a consent form indicating that they are aware of the risk of herpes transmission when a circumcision procedure, or bris, includes direct oral contact. The measure, which Mayor Michael R. Bloomberg strongly supports, would probably be the first regulation of the ritual in the United States, rabbis say. It would not affect the way most Jewish ritual circumcisions are performed — gauze or a sterile pipette is used to pull blood from the wound — nor would it ban the practice. But the issue being raised in New York coincides with moves in Denmark, Germany and other countries toward restricting or banning infant circumcision."

This program aired on September 13, 2012. The audio for this program is not available.