Communication

June 24, 2019

With 2020 race kicking into next gear, voters have lots to ponder on health care

Starting this week in Miami, 20 Democrats over the course of two nights will try to make the case that they deserve to be elected President. Now what will they and Republicans have to say about health care, which voters have declared a troubling issue that’s on the top of their minds?

In recent weeks, the current administration and members of the GOP could not have made clearer that Medicaid, Medicare, and, of course, the Affordable Care Act will be major matters to tussle over, still. Is health care a fundamental right or a privilege? Should the government assist the poor, working poor, and middle class with more affordable health care? Plenty of recent developments with federal social safety net programs will give politicians much to talk with voters about, including:

In Arkansas, a GOP-embraced notion — that the elderly, disabled, chronically ill, and children, as well as others who get health care help through the federal Medicaid program also should work for their benefits or prove they cannot work — has flopped, as opponents warned it would. Instead, Harvard researchers found that Draconian measures requiring Medicaid recipients to repeatedly prove they could not work, were seeking employment, or had some kind of jobs “caused thousands of poor adults to lose coverage without any evidence the target population gained jobs,” the Kaiser Health News service reported. KHN’s article said, “the Harvard study is the first to provide evidence that the [Medicaid policy] change left [program participants] uninsured and did not promote employment. The results, based on a telephone survey of about 3,000 low-income adults in Arkansas, concluded that the law befuddled enrollees and that its mandatory reporting requirements led many to unnecessarily lose coverage.”

June 23, 2019

Opioid crisis? ‘Not my fault,’ say surgeons and drug maker’s heir

by Patrick A. Malone

As the nation’s opioid and drug overdose crisis deepens, it can be hard to watch as the “Not My Fault” crowd clucks about its blamelessness in pushing potent painkillers that have played a part in killing more Americans in 2016 and 2017 alone than lost their lives in the Vietnam War.

The latest NMF protagonists include:

David Sackler, the outrage-fueling scion of the family that owns Purdue Pharmaceutical, the maker of OxyContin. That drug — and the relentless and inaccurate sales and marketing push that the Sackler family put behind it — helped to foster a calamitous wave of prescription painkiller abuse and addiction, deep media investigations and court cases have shown. OxyContin, in turn, assisted in opening the door to lethal abuses and overdoses of even stronger legal and illicit drugs, including the painkiller fentanyl and street heroin.

June 21, 2019

Pleas for ‘wellness’ moderation: Foods aren’t dirty, bad, or a cause for shame

by Patrick A. Malone

Moderation matters in all things, though its proponents often seem to get shoved aside by more extreme views. Now there is welcome new push-back against wellness hype by those who instead want science- and evidence-based approaches to health and nutrition to prevail.

In separate and unrelated expressions of their points of view, novelist Jessica Knoll (in a New York Times Op-Ed) and dietitian and nutritionist Ellie Krieger (in a Washington Post column) both take after the way that a certain chic crowd tries to get Americans — women especially — to adopt what they say is wrong thinking about food and eating.

Krieger (shown, above left) calls it cringe-worthy that individuals focusing on diet and nutrition reflexively now apply loaded, moralistic terms to food like good, bad, dirty, and unclean. She describes the problem she and others in the field have with this:

June 19, 2019

Is this any way to learn you’re dying — hearing MDs chat outside exam room?

by Patrick A. Malone

Ron Naito already had been rebuffed by one specialist about the severity of his illness. He was awaiting in a doctor’s examining room for his lab test results and a consultation with a second expert about his already advanced cancer. What happened next stunned the Portland, Ore., resident. But now he’s doing something to help other patients in this way too common situation.

Naito overheard his doctor and a medical student talking about him and his lab results as they passed by the open room door, saying a tumor in his pancreas was “5 centimeters,” and was “very bad.”

That was the way Naito, who has practiced as an internist for 40 years, learned his condition was terminal. The cruel delivery of that crucial news convinced him that he needed to spend what time he has left working with his medical colleagues about their communication skills, especially in conveying the news to patients that they are dying.

June 18, 2019

UCLA ripped for poor handling of another scandal over a staff physician

by Patrick A. Malone

USC, Ohio State, Michigan State, and now, UCLA: How can big universities, with all the supposedly smart folks who head them, be so blind and deaf to student complaints that school personnel may be sexually abusing them? And why do academics keep getting caught up in situations where they appear to or may be covering up wrongdoing against the young?

Officials at the University of California Los Angeles find themselves apologizing profusely for failing to disclose that they knew of accusations of inappropriate conduct by a gynecologist on the school’s staff while treating patients in university facilities, the Los Angeles Times reported.

Women say that Dr. James Mason Heaps wrongly touched their private parts, and UCLA learned of the accusations in 2017, putting the longtime staff gynecologist on leave in 2018. The school, however, did not disclose why Heaps was gone — until criminal charges were filed against him in recent days and he pleaded not guilty to them in court.

June 16, 2019

For Insys, infamy in two opioid crisis firsts: convicted founder and bankruptcy

by Patrick A. Malone

Insys Therapeutics, a drug maker that peddled powerful and addictive painkillers in sordid ways, entered yet another phase of its penalties for its criminal conduct: The firm in quick fashion agreed first to pay $225 million to resolve federal bribery charges, then promptly sought bankruptcy protection.

Federal prosecutors, who earlier had won criminal racketeering convictions against the firm’s CEO and other Insys executives, emphasized that the Big Pharma firm hasn’t declared itself insolvent in its bankruptcy action and will pay up for damages caused by Susbsys, its chief product.

Subsys is a liquid containing the super potent painkiller fentanyl. It is administered as a drop under the tongue and was supposed to benefit cancer patients with grueling pain. Instead, Insys CEO John Kapoor “used speaker’s fees and lap dances to lure doctors into prescribing Subsys for far more patients than the drug was approved for and cheated insurers into covering prescriptions for the costly medication,” the Washington Post reported. Kapoor and other Insys execs await sentencing after their federal felony convictions.

June 13, 2019

With seniors, special focus can be beneficial — in tough surgeries and more

by Patrick A. Malone

Recognizing that seniors face different health challenges than younger folks could help doctors and hospitals better safeguard older patients who undergo complex and demanding surgery.

Paying heightened attention to age’s changes also can be beneficial to older adults in protecting themselves from damaging falls and getting retirees to keep moving to stay fitter — without getting hung up on a mistaken exercise measure.

A specialty group within the American College of Surgeons may be on a beneficial course in recommending new geriatric guidelines for older patients, a rising number of whom undergo extensive procedures that once were considered risky for those of an advanced age, the New York Times reported. This is a significant issue in surgical practice, the newspaper reported:

June 11, 2019

Faith-based charity as the answer to crushing medical debt? Only in America.

by Patrick A. Malone

Praise be: Churches nationwide are leaping in with their congregations’ blessing and financial support, putting up small sums to buy up and wipe out one of the huge shames of the American health care system: patients’ medical debt.

The faithful work with RIP Medical Debt, a nonprofit organization based in Rye, N.Y., that provides the know-how to many kinds of donors to help eliminate bills that can crush patients and their loved ones for a lifetime, the Kaiser Health News service reported. Roxie Hammill wrote how this all works in modern medicine:

June 9, 2019

Uncle Sam forced to disclose secret list of 400 poorly performing nursing homes

by Patrick A. Malone

Federal regulators have given up the unwarranted secrecy enshrouding their watchdog efforts on the nation’s most problematic nursing homes.

With prodding from the U.S. senators from Pennsylvania, Democrat Bob Casey (above left) and Republican Pat Toomey (above right), the Centers for Medicare and Medicaid Services (CMS) disclosed its list of hundreds of nursing homes that perform so poorly they are on the brink of regulators’ most dire supervision.

CMS had declined to disclose its candidates for designation as a “Special Focus Facility” (SFF), preferring instead just to tell the public about its worst of the worst nursing homes, 88 facilities with the SFF tag that receive a targeted, higher level of inspection because of their poor performance. The most rigorous oversight can be resource intensive, and CMS can only scrutinize at the highest level a few poor performing homes, whose infamy is made public. When one facility “works its way off” an SFF designation by improving its failings, others are on the heretofore secret list to take their place.

June 7, 2019

In season of higher risk for kids, cautions about mowers and pool chemicals

by Patrick A. Malone

As the nation slips into summer and the statistical 100 deadliest days for kids, there are some timely reminders about keeping youngsters safer around swimming pools and the chemicals used with them and protecting them from the harms of riding mowers when the devices are run in reverse.

The Red Cross, of course, reminds that “10 people die each day from unintentional drowning, and on average two of them are younger than 14. Drowning is responsible for more deaths among children ages one to four than any other cause except birth defects. And among those 1-14, drowning is the second-leading cause of unintentional injury-related death behind motor vehicle crashes. For every child who dies from drowning, another five receive emergency care for nonfatal submersion injuries.”

The safety group, which urges parents to supervise kids closely near water and get them swimming lessons and instruction in ways to prevent water-borne mishaps, underscores that little kids drown most often at home — in pools, hot tubs, and spas, but also buckets, bath seats, wells, cisterns, septic tanks, decorative ponds, and toilets. Youngsters 5 and older drown more often in ponds, lakes, and the ocean.