Sources: Obama, GOP's Snowe work on health care compromise

The compromise plan would lack a government-run public health insurance option favored by Obama, but would leave the door open to adding that provision down the road under an idea proposed by Snowe, the sources said.

One of the sources said White House officials are "deep in conversations" with Snowe on a much smaller health care bill than Obama originally envisioned.

The modified proposal would include insurance reforms, such as preventing insurance companies from denying coverage to people with pre-existing conditions, according to the source.

The potential deal would give insurance companies a defined period to make such changes in order to help cover more people and drive down long-term costs. But if those changes failed to occur within the defined period, a so-called "trigger" would provide for creating a public option to force change on the insurance companies, the source said.

Snowe is pivotal to the debate because she may be Obama's last possibility for getting a Republican senator to support his push for a health care overhaul.

She is one of the so-called "Gang of Six" members of the Senate Finance Committee, three Democrats and three Republicans, involved in separate negotiations on the only bipartisan health care proposal in Congress so far.

However, the slow pace of those talks and recent partisan attacks by the other two Republicans in the negotiations have dimmed hopes for a breakthrough, leaving Snowe as the only Republican senator that White House aides believe they can work with on the issue.

Snowe first proposed the so-called "trigger" idea for a public option months ago, and has talked to Obama about it on several occasions, according to a source familiar with the discussions.

The source told CNN that the White House staffers increased their phone calls to Snowe aides and their interest in her trigger idea this week.

Obama and Democratic leaders seek a solution that could win support from a Republican or two, and more importantly, help bridge a divide among Democrats on the public option issue.

Allies of the president hope that if Snowe accepts a health care agreement, she might also bring along her Republican colleague from Maine, moderate Sen. Susan Collins.

Getting some Republicans to sign onto a proposal would improve Obama's chances of gaining the support of key moderate Democratic senators such as Ben Nelson of Nebraska, Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas. All three are skeptical of a government-run public option supported by their more liberal fellow Democrats.

Despite the flurry of direct talks this week between Snowe and White House staff, Snowe aides insist she remains engaged in the "Gang of Six" bipartisan talks that have been going on for months. Those talks have focused on creating nonprofit health insurance cooperatives instead of a public option to force competition and lower medical rates.

The source familiar with Snowe's discussions with the White House said Snowe's trigger idea isn't being considered in the bipartisan negotiations because of early resistance from fellow Republican negotiators, especially Sen. Mike Enzi of Wyoming.

Enzi and the other Republican negotiator, Sen. Charles Grassley of Iowa, insist they are still committed to the bipartisan negotiations. However, their recent sharp criticism of Democratic health care proposals favored by Obama has caused tense relations with the White House.

Source by CNN News

High Blood Pressure

According to recent estimates, about one in three U.S. adults has high blood pressure, but because there are no symptoms, nearly one-third of these people don't know they have it. In fact, many people have high blood pressure for years without knowing it. Uncontrolled high blood pressure can lead to stroke, heart attack, heart failure or kidney failure. This is why high blood pressure is often called the "silent killer." The only way to tell if you have high blood pressure is to have your blood pressure checked.

Get the facts on high blood pressure and how to live a heart-healthier life. Find out how you can reduce your risks for heart attack and stroke with proper monitoring by a healthcare provider and simple lifestyle changes, even if you have high blood pressure.

Potential Impact of Swine Flu: An Expert Interview With Neal A. Halsey, MD

The outbreak of swine influenza A (H1N1) viral disease is continuing to grow in the United States and globally, with 91 laboratory-confirmed US cases and 1 death, according to US Centers for Disease Control (CDC) information updated April 29 at 11 am EST. The World Health Organization (WHO) has issued a phase 5 pandemic alert, and the CDC has implemented its emergency response and warned that the more recent illnesses suggest a pattern of more severe disease associated with this virus in the United States. Because most people are not immune to this new viral strain, the CDC expects more confirmed cases, more hospitalizations, and more deaths in the near future.
To learn more about the potential impact of H1N1 viral disease on public health, as well as treatment and prevention strategies, Medscape Infectious Diseases interviewed Neal A. Halsey, MD, professor in the Department of International Health, Bloomberg School of Public Health, Johns Hopkins University in Baltimore, Maryland. Dr. Halsey's primary research and teaching effort is directed toward the prevention of infectious diseases with the safest vaccines possible. He has conducted or participated in epidemiologic studies of vaccine-preventable diseases and phase 1, 2, and 3 vaccine trials for influenza, hepatitis B, hepatitis A, inactivated polio virus, pertussis, Haemophilus influenzae type B, tetanus, Lyme disease, rotavirus, and Argentina hemorrhagic fever viruses

Medscape: How serious is the swine flu situation?
Dr. Halsey: The swine flu changes things and will change priorities for many people. The evidence that we have so far is that this does represent a potential threat to global public health, and a lot of resources are going to have to go into trying to prepare as best we can to minimize the impact.
That will include development, as rapidly as possible, of vaccines against this new strain and making those vaccines rapidly available. If we see more widespread transmission, especially this year, then drug therapy will be an important part, especially here in the developed world.
We need low-cost drugs against influenza in the developing countries as well, because we won't have enough vaccines to protect the population against this new virus. We don't have sufficient vaccine production capacity in the world to make enough vaccine for everybody.
The biggest concern I have is that this will distract us from use of other vaccines that also can protect against disease, like the new pneumococcal vaccine, and even the push to continue to introduce the Hib vaccine. But this new influenza is a serious threat.

Medscape: Are existing influenza vaccines effective against the new strain?
Dr. Halsey: No.

Medscape: How long would it take for a new vaccine to be developed and produced against this virus?
Dr. Halsey: That's what the manufacturers are going to be asked this week, and the answer, with the traditional method, is that we usually give manufacturers 4 to 6 months. They find out about the virus that's going to go in at the end of January, beginning of February, each year, and they make the vaccine, and make it available beginning as early as the end of September, beginning of October.
They've already been making the vaccine they thought was going to be in widespread use, and the key question is whether they should stop what they're doing and put the effort into producing vaccine against this new strain, and that will have to be answered.
There are some new technologies that are being used that may be more rapid in terms of making new vaccine, but they have not yet been widely used. All vaccines currently approved for use require eggs for production, and the supply of eggs is likely to be limited and the manufacturers do not have the capacity to produce enough vaccine for everyone, so there will be shortages.
A number of the manufacturers are experimenting with making cell-based vaccines that don't require eggs; that also could speed up the process, but so far, none of those vaccines that I know of has been approved for use. If we had the production capacity using these cell-based vaccines, it could be more rapid.
I'm sure that both the CDC and WHO are meeting with manufacturers of flu vaccines, and they're all looking at this, trying to determine what their capability will be, but we don't have any answers yet.

Medscape: Are antiviral drugs such as Tamiflu effective against this strain?
Dr. Halsey: Oseltamivir, or Tamiflu, and zanamivir (Relenza) are effective against this strain, but amantadine and the older drugs are not. They've tested the virus and it is susceptible to oseltamivir and zanamivir, which is the only good news out of what we've heard so far.

Medscape: Are there any concerns, with this new strain being a mixture of swine and avian and human strains, that this was in any way genetically engineered or terrorist-related?
Dr. Halsey: No, it doesn't look that way to me. We have been anticipating a potential pandemic from a virus that would come through that same kind of mixing. We know that especially pigs, or swine, are a great mixing bowl, because they are susceptible not only to the swine flu, but also influenza from birds and influenza from humans. So the same pig can have in its body simultaneously several different infections with several different viruses and allow for that mixing. This happens naturally, and that's part of why, especially in Asia, we've been seeing some problems with transmission. You don't need to invoke any concern about bioterrorism to explain how this may have happened.

Medscape: What do you see as the overall potential impact of this swine flu?
Dr. Halsey: The swine flu epidemic, or if it turns out to be a pandemic, which is what we're all concerned about, may turn out not only to have a significant effect on public health and potential mortality, but it could also potentially impair everything else we're trying to do with regard to immunization, in terms of using everybody available to deal with this problem.
It also could have a significant exacerbating effect on the global economy. They've already shut the schools in Mexico; they didn't have audiences for the soccer matches. You can imagine the impact it will have with regard to travel. Some individual countries in the European Union have issued some statements, or cautionary advisories, with regard to travel.
Imagine what the economic impact of loss of tourism in Mexico is going to be, and potentially the United States. So I see this as rapidly having an exacerbating effect on the current recession. This is not a small issue.
Dr. Halsey reports receiving research grant support from Wyeth for studies of pneumococcal disease in Guatemala and from Berna for studies of combination vaccines in Guatemala. He also serves on data and safety monitoring boards for Novartis and Merck.

Reference by Medscape

HIV reaches fights pandemic that already killed 25 million people

Scientists are finding the cure to stop a virus that has killed more than 25 million people. Research at the Lab targeting the immune response to HIV and viral mutation might stop the pathogen that causes AIDS.
Although current Human Immunodeficiency Virus (HIV) treatment hinders the infection rate and delays death, there is no HIV vaccine or cure available for the Acquired Immune Deficiency Syndrome (AIDS). The United Nations estimates 14 million children have been orphaned by this disease, and 40,000 Americans will likely become infected this year.
LANL researcher Bette Korber and her team are solving challenging problems regarding HIV evolution and transmission and, importantly, how the human immune system reacts to the virus. Korber's team is designing three vaccines to target this rapidly mutating virus. Animal tests are underway, with promising results and human trials will begin soon. These vaccines might finally deal a lethal blow to the AIDS virus.
"HIV expands and contracts like an accordion," Korber, recipient of acclaimed awards, told an audience during a Los Alamos lecture. "The mystery is why we can't clear it with our immune response."
The HIV virus's mechanisms make it extraordinarily good at avoiding triggering an immune response, making it nearly impossible to fight the infection. Korber's team's vaccine model is based on a mixture of synthetic proteins that address the virus's evasive nature. Not only does the HIV-1 virus mutate quickly, increasing its drug resistance, but its evolution affects the virus's sequence. The virus is also protected by a cloak of sugar molecules that prevents antibodies from blocking the HIV proteins used to invade the cell.
In mid-October, nine hundred experts convened at the international AIDS vaccine conference in South Africa. Doubts were expressed about whether a vaccine is on the horizon. "Fundamentally we don't understand enough about the human immune system and we don't know how the immune system deals with HIV," said Lynn Morris, conference co-chair.
Korber's HIV immunity research might quickly turn the tides.

Additional AIDS Research

A Los Alamos National Laboratory mathematical model provided answers for the first time about offspring from a virus closely related to that which causes AIDS.
Thanks to this model, LANL researcher Alan Perelson and colleagues found that a single Simian Immunodeficiency Virus (SIV) produces about 50,000 offspring (viral burst) from a single cell, far more than previously believed. SIV and HIV infect hosts in highly similar ways.
With this information about SIV, AIDS researchers can more effectively create methods to reduce the number of virus progeny and limit infection.
Together, LANL AIDS researchers may soon find the answer to destroy this plague that is possibly the most dangerous disease the world has witnessed.