Drug-resistant superbugs are a 'fundamental threat', WHO says

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Anne Miller showed the world what a miracle drug looks like.

The 33-year old nurse had been sick for a month after suffering a miscarriage in 1942. Her temperature spiked to as high as 107 degrees as she lay dying from childbed fever, once a major killer of young women.

"By an incredible stroke of luck, her doctor gained access to one of the first tiny batches of penicillin, which was not even commercially available yet," Dr. Martin Blaser writes in his book, "Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues".

"Her recovery began within hours. The fever broke, the delirium ended, she could eat, and within a month she had recovered. It was the scientific equivalent of a miracle."

Click through 21 hacks to reduce your healthcare costs this year:

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21 hacks to reduce your health care costs this year
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21 hacks to reduce your health care costs this year

1. Use Generics

If your doctor prescribes you a brand-name drug, ask whether it would be OK to use a generic substitute. Generics can be significantly less expensive, and often there’s no difference in outcome. Medicare enrollees who opted for generic drugs saved an average $1,923 per person in 2014, according to a report by the Generic Pharmaceutical Association.

Read: 10 Ways to Survive Rising Health Care Costs

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2. Stick With In-Network Providers

Your insurer has deals with certain providers that will give you the best price and guarantee that the treatment will be covered. Going out of network almost always means that you’ll have to pay higher prices. Out-of-network providers charge patients on average 300 percent more, or higher, than the Medicare rate for many procedures, according to an analysis by America's Health Insurance Plans, a trade association representing the health insurance industry.

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3. Ask for 90-Day Prescriptions

Breaking down the monthly cost, you’ll likely pay less for a prescription for 90 days' worth of medicine than you will for a 30-day supply. Plus, you’ll only have to pay your copay once instead of three times.

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4. Get Moving

In addition to causing poor health, living an inactive lifestyle can have a dramatic impact on your medical bills. Sedentary adults pay $1,500 more per year in health care costs than adults who are physically active, according to a recent study by health advocacy organization Trust for America’s Health.

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5. Get a Pet

Not only can it be rewarding to have a pet, it can have tangible health benefits, too. The decline in office visits and the reduced frequency of obesity associated with pet ownership can lead to a health care savings of about $86 per year, according to a recent report from the Human Animal Bond Research Initiative Foundation.

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6. Shop Around for Care

For elective procedures, shop around to find the best price, and quality, for a procedure within your insurance network. Start by checking Healthcare Bluebook to get a sense of what a fair price for the procedure might be in your geographic area. Then call around to a few providers, and ask for a quote based on your health insurance.

“Even if you have insurance and you play by the rules, you could still pay five to 10 times more than you should if you don’t shop for care,” said Jeff Rice, CEO of Healthcare Bluebook.

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7. Check Your Bill for Errors

Nearly half of Americans say that they’ve received an inaccurate health care bill, according to a Wolters Kluwer Health poll. Protect yourself from overpaying by carefully reviewing every bill that you receive and disputing any potential errors. If anything looks off, or you don't understand a charge, contact the provider.

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8. Carefully Select a Health Care Plan

When it comes to deciding on a health insurance plan, choosing the correct one upfront can potentially save you thousands in medical expenses throughout the year. However, more than 90 percent of workers say they choose the same benefits every year, and almost 80 percent spend less than an hour researching benefit options before making a selection, according to a recent Aflac poll.

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9. Take Advantage of Wellness Programs

Companies are increasingly investing in wellness programs that encourage their workers to take steps — such as signing up for biometric screenings, health assessments and physical activity programs —to monitor and improve their health. To increase employee participation in such programs, a growing number of employers are now offering incentives like money, gift cards, reduced health insurance premiums or contributions to an HSA or FSA, according to a report last year by the National Business Group on Health.

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10. If You're Eligible for an HSA, Use It

If you have a high-deductible health plan at work, then you can fund a health savings account to use for medical expenses. Unlike an FSA, your HSA money is yours to keep and grows over time, so even if you don’t use it this year, you can tap it for medical expenses in the future. For 2016, you can put up to $3,350 for an individual and $6,750 for a family into an HSA to use for medical expenses.

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11. Shop Around for Drugs

Just as medical providers offer different prices, so do drugstores. A recent search on GoodRx.com for a 30-day supply of Lipitor found prices ranging from $10 to more than $90.

Retailers like Walgreens and Costco have prescription savings clubs, which offer a discount on generic prescriptions and often price match their competitors. The Walgreens program also provides a 10 percent discount on care at the store’s health clinics.

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12. Avoid the Emergency Room

Unless you have an actual emergency, stay away from the emergency room. Visiting a doctor’s office or urgent care clinic typically costs much less, and is often a less frenzied experience.

Choose carefully, though, because urgent care clinics that are owned by hospitals could charge the same rate as their parent company. “You’ll pay anywhere from four to 20 times the price by not going to your doctor,” said Adria Gross, CEO of Medwise Insurance Advocacy, which helps people navigate the medical claims system.

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13. Negotiate Your Bills

If you’re paying out of pocket for a procedure, contact a hospital’s billing department upfront to see whether there’s any wiggle room in the price. If you’ve already had a procedure, but can’t afford to pay the bill, there might also be an opportunity to negotiate the size of the bill, or set up a payment plan that makes it more affordable.

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14. Try Telemedicine

More insurers and companies are offering benefits that include telemedicine, in which you can consult with a doctor online or over the phone for minor ailments, at a fraction of the cost of an in-patient visit. The average telemedicine visit is estimated at $40 to $50, compared to an in-person acute care visit at an average estimated cost of $136 to $176, according to a study commissioned by the Alliance for Connected Care. Bonus: You don’t have to leave the house when you’re under the weather.

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15. Consider Medical Tourism

Some 750,000 Americans leave the country every year for health procedures that are cheaper elsewhere or not affordable in the United States, according to the Centers for Disease Control. The practice of “medical tourism,” as it’s known, includes risks, such as trouble communicating or less-safe practices. However, the Medical Tourism Association estimates that traveling for medical treatment can net savings of up to 90 percent.

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16. Bundle Your Costs

Once you’ve reached your deductible in one year, consider scheduling any covered, elective procedures to also take place that year. That way, you can potentially avoid having to pay the full deductible in two consecutive years.

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17. Deduct Your Medical Expenses

You qualify to write off your medical expenses on your taxes if your medical expenses are more than 10 percent of your adjusted gross income, or 7.5 percent if you’re age 65 or older. Qualified expenses include doctor visits and premiums, fertility treatments and hearing aids.

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18. Go to Labs for Blood Work

If your doctor orders blood work or other lab tests, first ask the doctor whether they’re medically necessary. If yes, get the work done in a standalone lab, where prices tend to be cheaper than what you’ll pay by getting work done in a hospital or some doctors' offices.

Asking your doctor for a written lab order and taking it to a national laboratory group, rather than an in-hospital lab facility, could save you up to 90 percent on costs, according to a 2014 study by health care consultant group Castlight.

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19. Insure Yourself

Under the Affordable Care Act, if you can afford health insurance but choose not to buy it, you’ll have to pay a fine when you file your federal tax returns for that year. If you're uninsured in 2016, you could pay a fine of 2.5 percent of your household income, or $695 per adult and $347.50 per child under 18 — whichever is highest. In addition, going uninsured means that one medical emergency could become a financial disaster for you, depleting your savings or causing you to run up unnecessary debt.

Read: 5 Tax Law Changes for 2016 You Need to Know

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20. Strategize With Your Spouse

If both you and your partner have access to health benefits at work, compare the plans offered by both companies. Find out which one offers the richest benefits at the best cost for your family, and whether you might be able to save money by being insured separately.

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21. Move Somewhere Cheaper

The cost of getting insurance via the Affordable Care Act marketplaces plan varies drastically depending on where you live, according to recent analysis by GOBankingRates. Buying a plan in New York, the most expensive state in the country for these costs, for example, would mean signing on for a $3,000 deductible and a $366 monthly premium. A similar plan in New Mexico, by contrast, features a $2,000 deductible and premiums of just $181 per month, less than half of those in a New York plan.

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Blaser learned the details of Miller's case during a 1992 symposium at Yale. What happened next gave him chills, he says.

"In the third row, a small-boned, elegant, elderly woman with short white hair stood up and, with bright eyes, looked out across the room. She was Anne Miller, then in her 80s, given 50 more years of life by the miracle of penicillin," he recounts.

This is what doctors and patients alike have in mind when they think of antibiotics, says Blaser, a New York University microbiologist who chairs the Presidential Advisory Council on Combating Antibiotic Resistant Bacteria.

And while antibiotics can be miracle drugs, they've been abused and overused so much that they are often useless against bacteria that evolve much, much faster than humanity can invent new weapons.

On Wednesday, the United Nations General Assembly voted to take "a broad, coordinated approach" to go after antimicrobial resistance. "This is only the fourth time a health issue has been taken up by the U.N. General Assembly (the others were HIV, noncommunicable diseases, and Ebola)," the U.N. said.

Today, penicillin almost certainly would not help an Anne Miller. She'd at the least need an improved version of penicillin such as ampicillin, which has extra compounds added to counteract the tricks that bacteria have evolved to survive a round of antibiotic treatment.

Related: 'Nightmare Bacteria' Found in U.S.

Drug-resistant "superbugs" are now found virtually everywhere. They've developed as people pop antibiotics to treat colds, the flu, ear infections and various other ills caused by viruses and fungi that are not affected by the drugs. They grow in farm animals fed antibiotics not to treat disease, but to make them grow fatter and faster.

They're found in city sewer systems and in hospital sinks. The Centers for Disease Control and Prevention says in the U.S. alone, more than two million people are infected by drug-resistant germs each year, and 23,000 die of their infections. Globally, these antibiotic-resistant microbes kill 700,000 people a year.

The drug pipeline is not keeping up.

The last really new class of antibiotics was invented in 1984, according to the Pew Charitable Trusts. Every new antibiotic to hit the market since then - and there have not been many - is a variation on a decades-old design.

"If antibiotics were telephones, we would still be calling each other using clunky rotary dials and copper lines," says Stefano Bertuzzi, CEO of the American Society for Microbiology.

"Antimicrobial resistance poses a fundamental threat to human health, development and security," Dr. Margaret Chan, director-general of the U.N.' s World Health Organization, said Wednesday.

"We are running out of time," she added.

Related: Inside the Lab Searching for the Next Superbug

The World Bank Group predicted this week that the economic damage wrought by antibiotic resistant infections will wipe between 1 percent and 3.8 percent off global domestic product by 2050.

"The scale and nature of this economic threat could wipe out hard-fought development gains and take us away from our goals of ending extreme poverty," said World Bank president Jim Yong Kim. "We must urgently change course to avert this potential crisis."

It's not a new issue. Public health experts, infectious disease doctors, patients and advocates have all been warning about the problem for two decades. But antibiotic overuse persists, and the superbugs continue to pop up.

The most recent is the mcr-1 gene, found on a little clip of DNA called a plasmid that various species of bacteria can pass around and share like an internet meme. It gives them resistance to a last-resort antibiotic called colistin.

Related: What's so Super About Superbugs

The U.N. plans to lead a global effort to help countries fight the threat. While some are struggling just to provide clean water to their populations, others, like the United States, are fighting epidemics that reach into flagship hospitals and that don't discriminate between rich and poor.

Vaccines can help, as can better hygiene, safe water and better use of antibiotics.

On-the-spot tests that indicate right away whether a patient has a bacterial infection or a virus can help doctors fight back against demands for a prescription, and can help an anxious patient feel confident that drugs really won't help their wailing child's ear infection, says American Society for Microbiology President Susan Sharp.

Experts also say the wholesale use of antibiotics in farm animals has to stop. Eighty percent of the world's antibiotics now go into animal feed, and these animals are pooping out superbugs that have evolved in their guts. The mcr-1 gene has been found in slaughterhouses and pet stores.

The White House has embraced the issue, and the U.N. wants to press countries around the world to do the same — especially since germs don't respect borders.

Related: Here's Why Superbugs Scare Doctors

Report after report has done little to stop the clamor for antibiotics and even doctors are failing to heed the warnings. A third of antibiotic prescriptions written in the U.S. are for viral infections, the CDC says.

"We clearly aren't moving the needle," Sharp says. She says it will take an education campaign on the scale of the ongoing effort to let people know about the dangers of tobacco.

"Patients are not aware that there are side effects," she said. 'Even when you do need them, there are side effects." Those effects range from diarrhea to antibiotic resistance.

Every time someone uses an antibiotic, the bacteria in their body begin to evolve. It's impossible to wipe out every single bacterium in the body, so those that survive are stronger, and can not only re-infect the patient, but can be passed to others.

That means the antibiotic doesn't work as well the next time.

Related: Antibiotic Resistance Hurts Healthy Kids

The outcome can be tragic. Just ask Everly Macario, whose baby son, Simon, died in 2004 from a methicillin-resistant Staphylococcus aureus (MRSA) infection.

"Simon woke up not acting like himself and my husband was really worried, so he actually decided to take him to the emergency room," Macario told NBC News.

The previously bright, healthy year-and-a-half-old baby was dead within a day.

"It's a parent's worst nightmare," said Macario, who has now become an advocate for the Infectious Diseases Society of America.

"I'm a few blocks away from the best hospital, smartest, most brilliant doctors with all the technology," added Macario, who lives in Chicago. She said Simon was fully vaccinated, breast-fed and had no serious health problems.

"I want people to wake up and realize that this isn't something that happens to other people."

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