ryanMembers of Congress are home in their districts for a week-long break, and many lawmakers are expected to get an earful from voters upset over many issues at the start of the Trump Administration, especially this: What the heck’s going on with health care?

Republicans have insisted for years now—counter-factually, as the evidence has amply demonstrated—that they had a cheaper, better, more inclusive alternative to the Affordable Care Act, aka Obamacare. The promised to repeal the ACA on the day they gained control of Congress and the White House. That hasn’t happened. Nor has the GOP proffered its vaunted replacement. Instead, the party had talked in recent days about an ACA repair.

But under fire from their most conservative party members, Republican leaders have thrown up what they call an outline of Trumpcare. The GOP has moved from lots of R’s—repeal, replace, and repair—to some C’s and D’s: Costly, callous, divisive, and cruel. Those are some ways their retread plan elements (dubbed “déjà vu all over again” in one report) could be described. The outline still faces major challenges, not the least of which is whether a chaotic White House and a lumpen Congress can conduct the nation’s business and enact public policy.

vaping-300x200Some young users are experimenting with different ways to vape, modifying their e-cigarettes to increase the smoke and the high—and raising more concerns about the health harms of this hot pastime.

Researchers say they found that a quarter of the 1,800 or so of the youthful vapers they studied engaged in a practice dubbed “dripping.” They altered their e-cigarettes to expose the normally sealed heating element, and then they poured flavored vaping liquids directly on it. That created a bigger puff of smoke, which, when inhaled, produced a more intense high from the blast of nicotine and other chemicals vaporized from the flavored liquids.

This practice also potentially exposes them more to addictive nicotine and cancer-causing substances, especially byproducts that result from high-heat vaporizing of the flavored liquids, the researchers reported in their study, published in the medical journal Pediatrics.

ear-187x300Traffic, rock concerts, leaf blowers, and blaring head phones — these are among the many noise sources that have played a part in 40 million American adults suffering from hearing losses not caused by their work conditions, Uncle Sam says.

The federal Centers for Disease Control and Prevention, based on a study of more than 3,500 people who underwent tests and questioning, estimates that a quarter of Americans ages 20 to 69 suffer hearing impairment that constitutes “a significant, often unrecognized health problem.”

This diminished capacity, especially if untreated, can lead to “decreased social, psychological, and cognitive functioning,” the CDC says. Its study also reported that:

http://www.protectpatientsblog.com/wp-content/uploads/sites/69/2016/09/Food_and_Drug_Administration_logo.svg_-300x129.pngTo hear some powerful proponents tell it, Uncle Sam needs to really hurry up the government’s approval of drugs and medical devices. He’s got to make oversight over them easier, lighter, and less complex.

But consider just some of the health news in recent days:

nhlDo the leaders of professional hockey need to spend some time in the penalty box? It might seem so based on a report in the New York Times that the National Hockey League, as it battles its own players in court over the harms caused by repetitive head injuries, is adopting the dubious legal playbook used by pro football, Big Tobacco and Big Sugar.

The $4-billion-a-year NHL, it seems, has taken off its mitts, thrown them on the ice, and is throwing blows to challenge the ever-mounting, evidence-based research that finds that concussions are detrimental to brain health and can lead to the disease known as chronic traumatic encephalopathy or CTE.

The National Football League, after years of CTE denial, including efforts to undercut its medical science and to attack its researchers, conceded that repeated head trauma harmed its players, and pro football settled with them for more than $1 billion.

thomas-price-225Republicans jammed through their health policy guru in the middle of the night, and they and their new HHS Secretary are still trying to figure out what to do with the Affordable Care Act, aka Obamacare. Insurance markets are on the brink of chaos, and the mess is angering increasing number of Americans who may soon see their costs rise, their medical care decline, and their health imperiled.

The president and the speaker of the house continue to be at odds as to the timing of the GOP’s long-promised pledge to repeal and replace Obamacare, with the timeline stretching to the year’s end or beyond before the public gets to see the outlines or details of Republicans’ Trumpcare.

Proposals for ACA ‘repair’

marijuana-smoking-131013-300x200Although marijuana is marching toward legalization across the United States, expectant moms may wish to think long and hard still about smoking or ingesting a substance that has become as ubiquitous in some households as aspirin or a bottle of chardonnay. The New York Times has delved into this discussion, even as other news outlets recently have provided parental warnings about hype over apps for baby care and tossing some toxic homeopathic teething remedies.

Pot? Not for expectant moms

Let’s turn first, and not be blue noses about it, to why moms would consider pot while pregnant. Data show that few do (an estimated 4 percent of more than 200,000 women in one 12-year sample — though the number had doubled in recent time). For younger women, the answer may be, just because. They don’t equate it with risk but with recreation. They say they try to be cautious with it, just as they might curtail their alcohol consumption but still have a rare drink. Older and expectant moms may use pot, as many women do, because they find it helps with depression, anxiety, stress, pain, nausea and vomiting.

10650-insulin-diabetes-300x169Just under a century ago, a team of Canadian scientists made the breakthrough that led to widely available insulin as an effective treatment for diabetes, which then was a deadly disease. The researchers, who won the Nobel Prize, also made a jaw-dropping gesture to ensure their discovery would benefit the afflicted: They handed over their lucrative patent on insulin to the University of Toronto to ensure the fearsome illness would be conquered.

The university, alas, turned quickly to commercial drug makers, licensing them to produce the life-saving medication. And flash forward to now, and, after years of rising anger, a group of diabetes patients has sued three drug makers, asserting they systematically and fraudulently price-gouged them for their must-have treatment.

Insulin has become a $24 billion global market, with myriad profit-grabbing hands of distributors and supposed cost-controllers moving it from makers to patients, each middleman taking his piece. Patients say they’re aggravated that the various Big Pharma players appear to work in concert to send insulin’s price, in lockstep, skyrocketing. One vendor’s product carried a sticker price of $21 per vial two decades ago. It now costs $255 for the same amount.

harlanYes, there can be progressive steps in health care—and with all the controversy and change going on in the sector it’s worth spotlighting some of these:

Patients should get access to own health records, researchers say

  • Three researchers—Dr. Harlan Krumholz of Yale Medical School (photo right), Connecticut lawyer Jennifer L. Cox, and Yale student Austin W. Jaspers—deserve credit for publishing a pointed opinion piece in the JAMA Internal Medicine detailing the costs and needless obstacles patients confront when they want copies of their own health records. As Krumholz told Reuters of the study’s message about excessive records fees charged by doctors and hospitals:  “Higher costs are a higher barrier for people to get their own information. Without that information it is not possible to correct errors in the record, get informed second opinions, donate your data to research – or share with others what is happening with your care.”  That’s spot on, doctor, as I have written recently and in my book,  The Life You Save: Nine Steps to Getting the Best Medical Care, and Avoiding the Worst. Uncle Sam has stepped in and tried to make it easier and more affordable for patients to get their own records, which Krumholz and company point out should be even more available now that they are digitized (he’s working on software to help, too). But states aren’t doing enough to help, except for Kentucky, which requires a free first copy on request, he and his colleagues say. My firm’s site contains information that may be helpful to those struggling to get their records. Here’s hoping that doctors, hospitals, and other caregiving facilities read the Jaspers, Cox, and Krumholz viewpoint, and, because it appears in one of their publications and Krumholz is a physician-researcher of growing influence, they heed it more.

Frank_luntz_2009-214x300With its furious attack on the Affordable Care Act, aka Obamacare, has the GOP become the proverbial barking dog that finally caught the bus it has chased for so long? Partisans continue to proffer notions for what might be part of Trumpcare.

But for the R’s in the House and Senate who have insisted for seven years that they would swiftly repeal and replace Obamacare, two more R’s, uncomfortably, are intruding: Reality, and the new buzzword Repair.

The Trump Administration—no surprise—hasn’t provided details. But it  told the federal Office of Management and Budget that it soon will submit proposed regulations aimed at stabilizing health insurance markets during any Obamacare transition.

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