Accessibility of Healthcare

March 22, 2019

Health care has its share of gaming by the deep-pocketed and powerful

by Patrick A. Malone

The rich and powerful may seem to run amok as the nation lurches through its latest gilded age. But sometimes:

They get reined in by public shaming, as seems to be occurring with a developing scandal over insider deals in the University of Maryland Medical System (UMMS).
It takes prosecutors to check abuses, as is occurring with the college admissions mess and notably how it harms students with genuine need for learning accommodations.

March 21, 2019

Rise in ‘medieval’ ills and other infections should send a big health warning

by Patrick A. Malone

Americans have battled for at least a decade over the role of government in individuals’ health, specifically through health insurance. But communities across the county may be grappling with the baleful and more direct consequences of society’s ignoring others’ well-being, as a public health crisis erupts over the re-emergence and spread of “medieval diseases.”

Say what you’d like about the vanity and superficiality of Tinsel Town. But it’s no matter for mockery that Los Angeles municipal employees are deathly afraid of and have been infected in the heart of the city’s busy downtown by typhus, a bacterial infection that brings high fever, stomach pain, and chills. It can be treated with antibiotics.

But its outbreak—168 cases since January 2018, including one staffer at Los Angeles City Hall—speaks to significant problems that cities especially are battling with infections borne by vermin, notably rats and the fleas that they carry, as well as lice.

March 13, 2019

Bureaucrats let medical device makers hide 1 million reports of patient harms

by Patrick A. Malone

If a surgical staple gun malfunctioned so seriously that it generated not a few dozen formal complaints but more than 10,000 reported incidents, shouldn’t patients, doctors, and hospitals have the right to know that information from the federal agency overseeing the safety of medical devices?

Apparently not. Or maybe not without a big kick in the pants from journalists.

Instead, the staff at the federal Food and Drug Administration turned a move to ease paperwork and bureaucracy into a giant and little-known system that lets medical device makers hide serious and significant numbers of reports about failures and flaws with at least 100 products, a Kaiser Health News Service investigation found.

March 12, 2019

For diabetics and dialysis patients, glimmers of better news on costs of care

by Patrick A. Malone

Diabetics and those with failing kidneys may have gotten a glimmer of relief from the staggering costs of caring for their conditions, as Big Pharma relented a tad with news it will put out a less-costly insulin product and federal officials suggesting Uncle Sam soon may be upsetting the flush profits of the dialysis industry.

DaVita Inc. and Fresenius Medical Care AG run more than 5,000 U.S. dialysis clinics and control around 70 percent of the market, Reuters news service reported in a story describing how Alex Azar, the powerful head of the federal Health and Human Services department, wants “a new payment approach for treating kidney disease that favors lower cost care at home and transplants.”

Why? As Reuters explains, “The goal is to reduce the $114 billion paid by the U.S. government each year to treat chronic kidney disease and end-stage renal disease, a top area of spending.”

March 11, 2019

With FDA chief gone, doubts rise on battles on nicotine, opioids, drug costs

by Patrick A. Malone

The Trump Administration has lost yet another top health official: So, what happens now with key policies pushed by Scott Gottlieb, the departing federal Food and Drug Administration commissioner, to battle teen nicotine abuse, cut skyrocketing drug costs, and attack the opioid crisis?

Administration officials insist Gottlieb wasn’t ousted, and the physician and onetime Big Pharma insider said he resigned from his post after a year on the job because he wanted to spend more time with his family (they hadn’t moved from Connecticut to join him in the nation’s capital).

Though Gottlieb received mixed or favorable media coverage as he leaves, his effect on the nation’s health is as cloudy as many high school vaping spots.

March 8, 2019

Catching up on your sleep this weekend? It doesn’t work, researchers find

by Patrick A. Malone

Americans may put off to the weekend catching up on sports scores, store sales, the latest news and more. But there’s a health essential that new research suggests cannot be put off for the weekend: a good night’s sleep.

The study, conducted at the University of Colorado and published in the science journal “Current Biology,” focused on a small group: three dozen healthy adults, split into three groups, with one allowed to sleep nine hours nightly, another getting just five hours of slumber, and a third with a staggered schedule. The last group, for five days, got five hours of sleep, followed by two days in which they could snooze for as long as they wished. They had to return, though, to the five-day cycle of five-hour slumbers.

Researchers followed their subjects for nine-day spans. The results will be un-welcome for proponents of weekend catch-up sleep, because it didn’t help in the ways that many of us would wish. As the Washington Post reported, those “who were limited to five hours of sleep on weekdays gained nearly three pounds over two weeks and experienced metabolic disruption that would increase their risk for diabetes over the long term. While weekend recovery sleep had some benefits after a single week of insufficient sleep, those gains were wiped out when people plunged right back into their same sleep-deprived schedule the next Monday.”

March 7, 2019

If a news reporter can get named a ‘Top Doctor,’ how do patients find reliable info on good MDs?

by Patrick A. Malone

Truth can be stranger than fiction, and for an investigative journalist covering the outrages of health care costs, ProPublica reporter Marshall Allen had a dream medical story call him on his phone: A well-known New York company reached out and told him he had been “honored” as one of the nation’s Top Doctors.

Not bad for a guy with an English degree from the University of Colorado and zero medical credentials, he reported in a recent, wry article.

He tried to explain to a saleswoman for the company how unqualified he was. But after a chat and after negotiating a “nominal fee” for his accolade — down to $99 from $289 — he bought a plaque and the right to promote himself as a specialist in “investigations” and a Top Doctor.

March 5, 2019

For soaring drug costs and overdoses, officials offer blame and shame

by Patrick A. Malone

As tens of thousands of Americans die from overdoses and many millions struggle with skyrocketing prescription medication costs, lawmakers and regulators in the nation’s capital plodded along with procedural steps they claimed would help attack what voters insist are some of their top public policy priorities.

On Capitol Hill, seven of Big Pharma’s top executives danced and dodged with members of a U.S. Senate Committee about who is to blame for the relentless rise and unaffordable cost of American drugs. Media reports of the Senate Finance hearing called it “political theater,” and it offered lawmakers a chance to vent at execs from AbbVie, AstraZeneca, Bristol-Myers Squibb, Johnson & Johnson, Merck, Pfizer, and Sanofi.

Sen. Ron Wyden, the senior Democrat on the committee from Oregon (shown above), blasted Big Pharma, telling the stone-faced corporate suits arrayed before him, “You’re willing to sit by and hose the American consumer while giving price breaks to consumers overseas,” the New York Times reported. He added that Big Pharma attempts to justify its prices, when so many patients cannot afford them, are “morally repugnant.” Sen. Bill Cassidy (R-La.) decried sky-high U.S. drug prices, especially compared with lower rates for patients elsewhere, saying, “It is almost as if the taxpayer has ‘stupid’ written on their face.”

March 1, 2019

Young people have rampant stress, anxiety & depression, plus trouble getting help from adults

by Patrick A. Malone

Recent news reports underscore how the nation’s youth are struggling more than had been believed with stress, anxiety, and depression.

The New York Times, based on nationwide polling by the respected Pew Research Center, reported that 70 percent of teenagers surveyed cited mental health concerns as a top issue for them. It ranked ahead of bullying, drugs, gangs, alcohol, and teen pregnancy.

As the newspaper reported, dealing with stress, anxiety, and depression hits teens hard these days, for a lot of good reasons:

February 27, 2019

Brokers pocket big bonuses for boosting cost of workplace health insurance

by Patrick A. Malone

As tens of millions of Americans struggle with workplace medical insurance that provides them with little benefit when they most need it, consumers may wonder just how naïve their employers may be in overlooking industry SPIFFs, SPIVs, and other little-discussed payments that jack up costs and may reduce benefits.

Before any confusion arises, don’t think about health insurance in high-minded terms, and, instead, as just another business transaction — maybe what occurs at the cheesy used car dealership in the neighborhood (ala actor Danny DeVito in “Matilda,” as shown above). There, customers have gotten savvy about bonuses (Sales Promotion Incentive Funds or Sales Promotion Incentives) ladled on salesmen to get them to move vehicles out of showrooms, asap.

Pro Publica, a Pulitzer Prize-winning investigative site, deserves credit for digging in to the medical insurance business to show how similar incentive programs proliferate in brokerages that purportedly help companies of all sizes figure how to cover their employees’ health needs.