Articles Posted in Accessibility of Healthcare

acsnewcases2020-300x128There’s good news out on declining deaths caused by one of the nation’s leading killers. But experts warn that the country will need to work hard to sustain a sharp drop in cancer mortality rates — mostly due to smokers quitting their nasty habit. That’s because other factors like rising obesity may undo the recent favorable results.

The findings reported by the American Cancer Society were heartening, as the New York Times reported:

“The cancer death rate in the United States fell 2.2% from 2016 to 2017 — the largest single-year decline in cancer mortality ever reported … Since 1991, the rate has dropped 29%, which translates to approximately 2.9 million fewer cancer deaths than would have occurred if the mortality rate had remained constant.”

CaseDeaton-300x169Even as economic inequity and inequality fuel a nationwide plague of “deaths of despair,” a runaway and inefficient health system hits Americans hard in their pocketbooks, in effect imposing an $8,000 annual tax on every household, a pair of leading economists say.

The crushing cost of the U.S. health system, exceeding $1 trillion a year, forces all Americans to pay this “tribute,” as if it were going to a foreign power, except this is a toll on themselves that we tolerate and allow, say Anne Case and Angus Deaton. The Princeton economists have reached this conclusion, as part of their research for their upcoming book, “Deaths of Despair and the Future of Capitalism.”

Case told economists at a San Diego conference: “A few people are getting very rich at the expense of the rest of us.”

freedhoff2-150x150Bravo, brevity. Four dozen words is all it takes for a doctor and noted writer on diet and obesity to offer plenty of sound advice on how to get and stay healthy.

Here are the suggestions from Yoni Freedhoff, associate professor of family medicine at the University of Ottawa, founder and medical director of Ottawa’s Bariatric Medical Institute, blogger at Weighty Matters, and author of “The Diet Fix: Why Diets Fail and How to Make Yours Work:”

“Don’t smoke. Get vaccinated. Avoid trans fats. Replace saturated fats with unsaturated if you can. Cook from whole ingredients — and minimize restaurant meals. Minimize ultra-processed foods. Cultivate relationships. Nurture sleep. Drink alcohol at most moderately. Exercise as often as you can enjoy. Drink only the calories you love.”

HowardUhospital-300x126Big hospitals keep getting bigger. But, contrary to what the suit-wearing MBAs may claim, the rising number of institutional mergers and acquisitions isn’t necessarily better for patients and their care.

At hospitals subjected to corporate wheeling and dealing, the quality of care got worse, or, at best, it stayed the same and didn’t improve, a new study in the New England Journal of Medicine reported.

Researchers scrutinized federal data “from 2007 through 2016 on performance on four measures of quality of care … and data on hospital mergers and acquisitions occurring from 2009 through 2013,” they said. These measures, the Wall Street Journal reported, included: patient satisfaction; deaths within a month of entering the hospital; return trips to the hospital within a month of leaving; and how often some heart, pneumonia, and surgery patients got recommended care. They looked at 246 hospitals involved in M&A activity,  controlling their findings with data from 1,986 institutions not similarly affected.

hal9000-300x225In recent years, doctors, hospitals, and popular media have promoted emerging treatments to the public with enthusiasm that in each case would turn out to be overblown. Just consider the red-hot chatter that once surrounded regenerative medicine, precision medicine, gene therapy, or immunotherapy. And now, it may be the turn of artificial intelligence to be hyped hard in health care.

Caveat emptor, as Liz Szabo reported for the Kaiser Health News Service. She sets the stage, thusly, about developments in a field that might worry some who remember Hal 9000 from “2001: a Space Odyssey”:

“Health products powered by artificial intelligence, or AI, are streaming into our lives, from virtual doctor apps to wearable sensors and drugstore chatbots. IBM boasted that its AI could ‘outthink cancer.’ Others say computer systems that read X-rays will make radiologists obsolete. ‘There’s nothing that I’ve seen in my 30-plus years studying medicine that could be as impactful and transformative’ as AI, said Dr. Eric Topol, a cardiologist and executive vice president of Scripps Research in La Jolla, Calif. AI can help doctors interpret MRIs of the heartCT scans of the head and photographs of the back of the eye, and could potentially take over many mundane medical chores, freeing doctors to spend more time talking to patients, Topol said. Even the Food and Drug Administration ― which has approved more than 40 AI products in the past five years ― says ‘the potential of digital health is nothing short of revolutionary.’”

flavorvape-300x225The Trump Administration kicked off the new year with a whimper not a bang with yet another of its attempts to corral the health nightmare of e-cigarettes and vaping by the nation’s young, while not upsetting the industry too much.

Starting Feb. 1, the federal government announced it will forbid the sale of most flavored cartridges for e-cigarette use, notably those with popular tastes like candy, fruits, and mint.

At the same time, though, vendors still can sell menthol and tobacco flavorings. And they can peddle flavored vaping liquids if they are used in the open tank systems that most often are so big, they are limited to shops or stores.

pickpocket-300x200If department stores, car mechanics, or restaurants billed their customers in the same way that hospitals and doctors do, prosecutors might have their hands full. That’s because what patients now accept in sheepish fashion as simple “errors” or misstatements or curious charges on their medical bills more correctly ought to be called something else: fraud.

That’s the reluctant but tough view now taken by Elisabeth Rosenthal, an editor, journalist, and onetime practicing doctor.

She has written an Op-Ed for the New York Times, her former employer, in which she recounted how she long has reported on health care costs and economics, including in her much-praised book, “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back.” She said she has listened to too many patient complaints, as well as experienced problems of her own, to keep allowing establishment medicine to deem its relentless chiseling, oops, a little mistake.

alexahhs-150x150cmsseemav-150x150Here’s a point to ponder: A quarter of Americans say they or someone they know has put off treatment for a serious medical condition due to cost. That’s the worst such response pollsters at Gallup have gotten on this matter in almost three decades.

Two people have a lot to say about Americans’ health care finances, including their insurance, drug prices, and protections if they are poor, old, young, or chronically ill, physically or mentally. But, gee, the duo of Alex and Seema just can’t get along. They’re not playing nice. It’s gotten so bad that their big bosses, Don and Mike, have called them both in for a tough chat about working together.

carecostdelaychart-300x215Now, if it were you and me, and the office politicking got so out of hand that it attracted enough national attention to potentially embarrass majordomos of the organization, wouldn’t there be a screen door banging with some suits also getting tossed to the curb?

crashempirestatebldg-240x300The U.S. government is on the brink of giving active duty military personnel half a legal loaf when it comes to a fundamental constitutional right — their chance to seek justice in the civil courts if they suffer harms while receiving medical services in noncombat situations.

If the U.S. Senate approves, as expected, a House-passed measure, and it is signed by the president, as he has said he will, active military members soon may be able to make medical malpractice claims, as they couldn’t before. But the disputes won’t be decided in the civil justice system. Instead, they will stay under military control.

That’s far less than ideal. To understand why, and how this compromise got struck, it’s necessary to dive a little into federal law.

ucipic-300x245
Elite researchers — professors and staff with ties to 20 of the nation’s top universities and the respected National Institutes of Health — may be failing to be as candid as institutions and laws require about their potential professional conflicts of interest, notably the significant sums they get from Big Pharma and medical device makers.

ProPublica, the Pulitzer Prize-winning investigative organization, and the Los Angeles Times jointly scrutinized the experts’ required disclosures, finding they not only fall short. They may fail to give the public a fair view of the credibility of their findings. And, in California, they may be a unique rip-off of the state’s top university system. The “UCs” provide research faculty with costly facilities and other support, as well as sharing its global renown — in exchange for revenue the experts may earn outside the system.

In total, after examining records on tens of thousands of university scholars and NIH experts, ProPublica not only has made public its “Dollars for Profs” database, it also quotes federal watchdogs as estimating that with the NIH alone, conflicts of interest with agency grants amounts to $1 billion.

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