Articles Posted in Preventive Care

Foxx-275x300Call it creepy or maybe a too-early April Fool’s joke. What else can be said about a Republican-backed measure, advancing in the House of Representatives, that puts Big Brother in charge— big time —in many workplaces via so-called wellness programs?

It’s called the  “Preserving Employee Wellness Programs Act.” This Orwell-inspired bill,  pushed by North Carolina Republican Congresswoman Virginia Foxx, gives employers scary control over their workers. Employees who participate in job-related health programs can be compelled to undergo genetic tests, and to provide the results to employers, albeit in supposedly anonymized fashion. If they fail to do so, they could face thousands of dollars in fines.

Disclosure of extremely personal, private medical information has been barred by the 2008 Genetic Information Nondiscrimination Act, aka GINA. It arose partly after a 1998 court case, in which clerical and administrative workers were allowed to sue their employer for requiring testing for “highly private and sensitive medical genetic information such as syphilis, sickle cell trait, and pregnancy” without their consent or knowledge during a general employee health exam. GINA has been key in blocking employers from tapping into genetic and other confidential medical information as part of increasingly popular but largely ineffective workplace wellness programs. Because most Americans, more than 155 million of them, get their health insurance at work, many companies have launched and expanded such programs as way to reduce their coverage costs.

cdc-logo-300x226When it comes to the nation’s health, the Trump Administration and the GOP-dominated Congress seem determined to prove they know how to do penny-wise and pound-foolish. They’re amply demonstrating this with proposed slashes in the nation’s basic budget for public health. They’re calling for a $1 billion cut for the Centers for Disease Control and Prevention, notably in the agency’s funding to combat bioterrorism and outbreaks of disease, as well as to battle smoking and to provide critical medical services like immunizations. Their target is the Prevention and Public Health Fund, set up under the Affordable Care Act, aka Obamacare. With the ACA under fire by partisans who want to repeal and replace it, the fund was already imperiled. GOP lawmakers, determined to cut domestic spending, seem disinclined to come up with substitute sums.

Andy Harris, a Maryland Republican congressman, physician, and House appropriations health subcommittee member, has been quoted as calling the public health money, “a slush fund.” He argued that, “It’s been used by the secretary [of health and human services] for whatever the secretary wants. It’s a misnomer to call it the Prevention and Public Health Fund, because it’s been used for other things, and it’s about time we eliminated it.”

The Obama Administration did embarrass Congress by tapping the fund to provide emergency aid last summer to Florida, Puerto Rico, Hawaii, and other states battling tropical infections, including Zika and dengue fever. Congress took a long recess vacation, as states clamored for help for mosquito eradication and vaccine development to deal with Zika, a virus that can cause severe birth defects and other harms.

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:

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.

Kellyanne_Conway-214x300Don’t  tune out because conventional wisdom suggests it’s “just” a program for the poor. The partisans’ planned push for changes to Medicaid could have significant consequences for millions of Americans, many of them middle-class, older, disabled, and sick.

The Medicaid changes, as various officials like counselor to the president Kellyanne Conway, have described them without detail for now, also could stagger state and local governments’ finances, including the already strapped District of Columbia, which might see a half-billion- to billion-dollar hole blown in its budgets.

Although significant and merited public attention has focused on the GOP’s crusade to repeal and replace the Affordable Care Act, aka Obamacare, and especially how it affects health insurance, many Americans may not be as riveted by what happens to Medicaid. Republicans have reviled for years now a part of the ACA’s reforms that expanded the government program, but only, as a result of a U.S. Supreme Court decision, if states agreed. Thirty-one states and the District of Columbia did so, 19 did not. This meant that 11 million Americans, most of them the working poor, received health care coverage via Medicaid.

skepticism-image-197x300At one point, medical experts recommended that physicians aggressively treat patients 60 and older so the top number of their blood pressure readings ran as close as possible to 140. Maybe not so, anymore. For a while, physicians were told to treat patients so their “good cholesterol” increased significantly. But maybe this approach doesn’t protect against heart disease after all. Pediatricians once warned parents to protect newborns by not exposing them to certain allergens, especially peanuts. If you haven’t had your head buried in the sand, that counsel, of course, has just changed 180 degrees.

Thanks are due to Aaron E. Carroll, a pediatrician, health research and policy expert, and columnist with the New York Times “Upshot” feature, for reminding — yet again, as repetition is the Mother of Learning — that medical news must be taken in by patient-consumers with a “dose of healthy skepticism.” This he says is especially true about reports on nutrition.

I’ve written about the harms that result from hype and the many, sometimes dramatic reverses in health and medical news. I’ve pointed out that there are accessible resources, such as the excellent healthnewsreview.org, to watchdog coverage of medical science and so-called advances. I’ve suggested that patient-consumers look closely at key elements in research stories, including how the work was done, how long the study ran, whether its data is visible and if it was published in a reputable medical journal. This will help savvy readers look askance, even at pieces in quality news sites — such as recent articles touting turmeric or eating lots of hot peppers.

pthiel-200x300Although attention has focused on the GOP-promised repeal and replacement of the Affordable Care Act, other big changes also are afoot in the federal government that will have significant effects on health care in this country.

There are appointments pending from President Trump at the federal Food and Drug Administration and the Centers for Disease Control and Prevention. Sonny Perdue, the administration’s pick for Agriculture secretary, also will play a big public health role, as will the personnel decisions that may be made at the troubled National Institutes of Health, where, for now, Francis Collins will continue to lead.

Will the FDA be run by a venture capitalist?

It wasn’t that long ago — see those classic black-and-white movies — when hospitals commonly cared for many different kinds of patients in large open wards. Young volunteers, women known as “candy stripers,” could be seen rolling carts down the aisles between the many rows of beds, selling cigarettes. Families might pop in for a visit, carrying for their sick kin a chicken dinner on a plate covered by a white napkin.

With the huge changes that the Affordable Care Act has brought to hospitals and American health care, and with the shifts that are yet to come if Obamacare gets repealed and replaced, it’s easy to forget how significantly and rapidly medical services continue to transform.

Female_black_symbol-200x300Modern medicine isn’t addressing women’s distinctive health care needs as optimally as needed, with research further showing it may be time to dial down expectations about breast cancer screening, while heightening physicians’ awareness and best practices in eliminating gender biases.

Women also may want to keep close tabs on how changes with the Affordable Care Act affect them, and they may be well-served to remind themselves about Texas’ sudden surge in maternal deaths and one of health care’s major, gender-based debacles in hormone treatments for females.

Over-treatment tied to mammograms

price-portrait-300x253The Republican-controlled Senate has launched itself in a late-night session on the path to its long-pledged repeal and replacement of the Affordable Care Act, aka Obamacare. The GOP-controlled House on  Friday the 13th followed close behind.

Lawmakers have chosen a complex parliamentary path. GOP members are expressing confusion about their way forward, even as doubts are being voiced by GOP governors in states where the ACA has expanded health care for the poor through Medicaid. The president-elect has called for swift action — insisting on not just Obamacare’s repeal but also its replacement with an undefined plan that he says will provide health care coverage that’s better than what exists now and for more Americans.

With big, many, and byzantine legislative steps needing to be taken even beyond “repeal,” can the ACA be replaced, too — and with what?

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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