Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.

[Q]: Paragraph: The story devotes its second paragraph to cost, including how that cost may differ depending on whether patients have insurance. Well done. This is a really close one. The story does a lot of things well here. It notes that, in one trial, there was no difference in the benefits between Xofluza and existing flu treatment drug oseltamivir (better known as Tamiflu). However, it does not actually quantify the benefits associated with Xofluza. Instead, the story states that it “may alleviate some symptoms and shorten the time patients feel sick.” We approve of the cautious language used throughout the story, but we like to see quantified benefits in instances where the information is available. In this case, an article published in the New England Journal of Medicine in September reported that Xofluza reduced the “time to alleviation of symptoms” by a mean of 25-38 hours, compared to placebo (the difference depended on the age group of the patient). Ergo, a not satisfactory rating here. The story addresses this issue head on, earning it a solid satisfactory rating from us. One point that would have made it even stronger would have been to note that the company selling Xofluza warns that pregnant women and nursing mothers may want to avoid the drug, as it is not known whether the drug may harm the fetus or if it would pass into breastmilk for nursing mothers. The story does a good job of describing the supporting evidence clearly and concisely. No disease mongering here. In fact, the story provides good context on the risks posed by influenza. The story incorporates input from two sources at the FDA, but the information appears to stem from an FDA statement. Information from pharmaceutical companies is clearly marked, but we really look for news stories to incorporate input from independent sources — beyond what may be available in a news release. The story addresses the similarities (and differences) to other drugs that address flu symptoms, particularly oseltamivir (Tamiflu). The story notes that Xofluza has received FDA approval. As noted above, the drugs similarities and differences to existing pharmaceutical treatment options was laid out clearly. The news peg here was FDA’s approval of the drug, which is also made clear. The work goes well beyond what you would find in any news release. We particularly applaud the story’s discussion of viruses developing resistance to antiviral drugs. Claim: F.D.A. Approves New Drug for Flu
[A]: This story is one of two we are reviewing that focuses on FDA’s approval of a drug designed to speed patient recovery from flu symptoms (the second story is from ABC News). The drug is baloxavir marboxil, marketed under the trade name Xofluza. This New York Times story hits most of the points that we want to see in a story about a new drug. The criteria that we use at HealthNewsReview.org to review health-related news stories were not developed in a vacuum. Rather, these are the criteria we feel are essential to allow patients and health care providers to make informed decisions about diagnosis and treatment options. While we do ding it on a couple things, the story does not exaggerate the findings, and provides people with the fundamental details they need to be informed patients. We were especially pleased that this story did not perpetuate misinformation that’s developed around this drug — that is, that it could help reduce transmission of the virus. To date, there is no evidence to show that as a benefit.


[Q]: Paragraph: "During a recent appearance on The Daily Show, guest host John Oliver and Sen. Rand Paul, R-Ky., engaged in a lively exchange on health insurance. One of the issues they discussed was the high cost of health insurance. Paul, an eye surgeon, is strongly opposed to President Barack Obama’s health care law. During the interview, Oliver pressed him on how to get more Americans signed up for insurance. Paul told Oliver that according to the most recent statistics,  ""85 percent of people had insurance, so 15 percent didn't. So what you need to do is look at who are the 15 percent, and why don't they have insurance? Of the 15 percent who didn't have insurance, half of them made more than $50,000 a year. Why didn't they buy insurance? Because of the expense. They were young healthy people."" In this fact-check, we’ll check whether the cost of insurance is the biggest barrier to uninsured Americans. In a separate report, we’ll look at his claim that half of the uninsured made more than $50,000 a year. Survey data consistently shows that cost is the biggest barrier to uninsured Americans obtaining coverage. When the Kaiser Family Foundation’s June 2013 health tracking poll asked uninsured respondents for the main reason they didn’t have health insurance, a plurality of 40 percent cited cost. The second-biggest factor, at 26 percent, was related to employment, such as being unemployed or having a job that doesn’t offer health insurance. These two reasons aren’t mutually exclusive -- someone could have told the pollster that their lack of a job was the biggest reason but also find cost to be a barrier to obtaining insurance. The only answer in the poll that suggests the respondent doesn’t face a cost obstacle is ""doesn’t need insurance,"" which was the answer of only 11 percent. In another survey, the 2011 National Health Interview Survey, conducted by the Centers for Disease Control and Prevention, researchers asked, ""Which of these are reasons you stopped being covered or don’t have health insurance?’’ Respondents were allowed to choose more than one reason. In this survey, too, a plurality -- 42 percent -- cited cost. Three other reasons cited are compatible with cost being an obstacle -- a lost job or a change in employment (26 percent), an employer that didn’t offer insurance (11 percent) and ineligible due to age or leaving school (9 percent). Just 6 percent cited ""other,"" which included ""didn’t want or need coverage,"" among other answers. ""The cost of insurance is a major reason why people are uninsured -- Sen. Paul is right about that,"" said Jonathan Oberlander, a health policy professor at the University of North Carolina School of Medicine. ""People without access to employer-sponsored coverage have a hard time affording it on their own, and that accounts for most of the uninsured."" Our ruling Paul asked, ""Why didn't (uninsured Americans) buy insurance? Because of the expense."" Survey data supports him. A plurality of respondents in major surveys of the uninsured specifically cite cost as a barrier, and relatively few indicate that going uninsured is a voluntary choice." Claim: Why didn't (uninsured Americans) buy insurance? Because of the expense.
[A]: "Paul asked, ""Why didn't (uninsured Americans) buy insurance? Because of the expense."" Survey data supports him. A plurality of respondents in major surveys of the uninsured specifically cite cost as a barrier, and relatively few indicate that going uninsured is a voluntary choice."


[Q]: Paragraph: "Every Republican presidential candidate opposes Obamacare, but Ohio Gov. John Kasich stands out for being the only one who took advantage of the program’s Medicaid expansion option. Former Florida Gov. Jeb Bush wasn’t going to let that choice go unnoticed. Bush touted his opposition to expansion in Florida during a debate in South Carolina. ""The (Florida) governor was supportive of doing what John did,"" Bush said Feb. 13. ""So was the Florida Senate. A committed speaker of the House asked me to go as a private citizen to make the case against the expansion. I did, and it wasn't expanded there."" To which Kasich shot back, ""When Jeb was governor -- his first four years as governor -- his Medicaid program grew twice as fast as mine. Okay? It's just a fact."" We can’t resolve which man is more fiscally responsible, but we can compare Medicaid spending trends. A decade and a half separates the periods -- 1999-2003 for Florida and 2011-15 for Ohio -- but with due regard for the vast change in circumstances, the numbers can speak for themselves. Kasich’s campaign provided Medicaid spending numbers for both Ohio and Florida and we confirmed them with independent sources in both states. The spending amounts, in millions of dollars, include both federal and state contributions to Medicaid. Ohio 2011 2012 2013 2014 2015 Change overall $17,681 $18,401 $18,857 $20,859 $23,467 32.7% Yearly change 4.1% 2.5% 10.6% 12.5% Florida 1999 2000 2001 2002 2003 $6,947 $7,764 $8,901 $10,220 $11,437 64.6% Yearly change 11.8% 14.6% 14.8% 11.9% (In millions of dollars) Source: Florida State University; State of Ohio You can’t compare the amounts directly because inflation changes the value of the dollars across the decades. But in terms of growth, Medicaid spending did rise twice as quickly under Bush than it has more recently under Kasich. But we wouldn’t advise drawing simple conclusions from this. The factors behind the numbers Florida’s Medicaid budget did rise rapidly during Bush’s first term, largely due to more spending on long-term care. An Urban Institute report in 2002 said that as Bush took office, Florida had ""a full-blown crisis"" in nursing homes. ""Chronic staffing shortages led to an erosion in quality of care, which in turn led to lawsuits that resulted in extremely large awards for complainants and skyrocketing liability insurance rates for the industry,"" the report said. Larry Polivka now heads the Claude Pepper Center, a public policy analysis group at Florida State University. In the early 2000s, he served on an advisory committee set up to suggest ways to fix problems in the long-term care system. Bush adopted many of the recommendations, such as more nursing home staffing, and they were not cheap. ""Bush increased funding in the long-term care part of the budget very substantially,"" Polivka told us. A 2002 assessment by the U.S. Health and Human Services Department echoed Polivka’s point. ""In January 2001, Gov. Jeb Bush partly unveiled his ‘elder-friendly’ initiative, which called for significant increases in funding for nursing homes and nursing home quality of care reform,"" according to the report, which noted Bush signed the changes into law in May 2001. Polivka said the state has a higher proportion of senior citizens than other states and anything done with nursing homes and other long-term care services will have a substantial impact on spending. Polivka said it didn’t help that the state also went through a brief recession in 2001. Unemployment rose over 2 percentage points in 2002. When the economy goes down, more people turn to Medicaid. Still, Polivka said the main driver in Florida centered on nursing home care, community-based care and at-home care. In Ohio, 15 years later, the economy helped the state. Unemployment dropped by nearly half, from 9.2 percent down to 4.7 percent. That eased demand on Medicaid. But the state did many things directly to rein in Medicaid spending. Amy Rohling McGee, president of the Health Policy Institute of Ohio, told us that Kasich focused on chronic illnesses, like asthma, and long-term care. McGee said administration policies played a significant role in trimming the rise in Medicaid costs, but she also noted that other trends were at play. ""It’s hard to tease out what reduces health care spending growth,"" McGee said. ""It’s likely a combination of factors. Experts around the country noted that healthcare spending was rising at a slower pace in recent years. Part of that was a post-recession slow down. Part of it might have been the Affordable Care Act. But changes in Ohio also made a difference here."" Our ruling Kasich said that Florida’s Medicaid spending in the first four years of the Bush administration went up twice as quickly as they did during Kasich’s first four years in Ohio. The spending numbers bear that out. However, comparisons across very different states at very different times should be used with caution. Large national trends in health care inflation and the economy played a significant role in Medicaid spending in both states. Bush in Florida faced higher health care inflation and an economic slump. Ohio saw an easing of health care spending and an improving labor market. Still, budget and policy decisions by the two governors had an impact on Medicaid spending. The statement is accurate but it needs additional information." Claim: When Jeb (Bush) was governor, his first four years as governor, his Medicaid program grew twice as fast as mine.
[A]:
Kasich said that Florida’s Medicaid spending in the first four years of the Bush administration went up twice as quickly as they did during Kasich’s first four years in Ohio. The spending numbers bear that out. However, comparisons across very different states at very different times should be used with caution. Large national trends in health care inflation and the economy played a significant role in Medicaid spending in both states. Bush in Florida faced higher health care inflation and an economic slump. Ohio saw an easing of health care spending and an improving labor market. Still, budget and policy decisions by the two governors had an impact on Medicaid spending. The statement is accurate but it needs additional information.