Articles Posted in Conflicts of Interest

ascension-st-vincent-riverside-hospital-300x200The nurses complained, and so did a handful of doctors. The patients howled. Yet, for years, administrators at a Florida hospital ignored the repeated alarms, critics say.

Now, 350 lawsuits have been filed and 100 more are expected, all asserting that Dr. Richard David Heekin, a seasoned orthopedist, suffered from a progressively debilitating, rare, neurologic condition that significantly impaired his capacity to perform what should have been common, uncomplicated knee and hip replacements, putting patients in harm’s way, NBC News reported.

Instead, during his flawed procedures, bones fractured, tendons ruptured, and nerves were severed. Patients required costly, painful, and unnecessary revision surgeries.

unoslogo-300x190UNOS, the independent medical network responsible for procuring and distributing human organs for transplants in this country, needs big changes because it is failing desperate patients, making screening errors, among other missteps, that have killed dozens of them and caused hundreds to develop procedure-related diseases.

The U.S. Senate Finance Committee reviewed hundreds of thousands of pages of subpoenaed documents and other material and investigated the nation’s transplant network for 2½ years, assailing UNOS  for its operational and oversight laxity, the Washington Post reported:

“Testing errors and overlooked communications [in organ procurement] allowed the transmission of cancer, a rare bacterial infection, and other diseases …The errors included failures to identify disease in donor kidneys, hearts and livers, as well as mix-ups in matching blood types and delays in blood and urine tests that were not completed before transplant surgeries occurred, the investigators concluded in a report obtained by The Washington Post. The Senate committee partly blamed lax oversight of organ procurement organizations (OPOs), the regional nonprofits responsible for collecting donated organs, by the United Network for Organ Sharing (UNOS), the Richmond-based contractor that oversees the system. It listed as problems careless treatment of donated organs, organs lost in transit, and technological issues.”

fdamattholman-150x150The ink was barely dry on statements from the head of the federal Food and Drug Administration about a planned external, independent review of the agency’s tobacco oversight division when one of its top regulators created a personnel stink of his own.

Matt Holman, chief of the office of science in FDA’s much-criticized Center for Tobacco Products, ended his 20-year government career.

He quit — to go to work for Philip Morris International, the global tobacco conglomerate and maker of Marlboros.

debtnprkhnnursinghomesuits-247x300When seniors need full-time institutional care, or when the injured or debilitated require similar 24/7 attention, loved ones — and even friends — must take care to read and re-read any documents that nursing homes and other long-term care facilities shove before them to sign during the stressful admissions process.

That’s because the owners and operators of the facilities soon may create a financial nightmare for the unwitting document signers, fueling what is the huge shame of the U.S. health care system: medical debt.

Most regular folks might think that the financial obligations incurred in long-term care facilities rightly belong to the adult residents. They’re 21 and older, and unlike minor kids carted into urgent, or emergency rooms for treatment, the residents typically have, until their situations suddenly shift, been responsible, including legally, for their lives and personal business.

charges-150x150Consumers should brace themselves for increasing costs of yet another key component of most families’ budgets: the price of health insurance premiums. Even if Congress can’t get its act together to extend coronavirus pandemic-related subsidies for millions of Americans covered under Obamacare, insurers in individual marketplaces across 13 states and Washington, D.C., are looking to raise rates an average of 10% next year.

Those are the annual findings of the Kaiser Family Foundation, which scrutinized preliminary rate submissions for Affordable Care Act policies sold on public marketplaces in the District of Columbia, Georgia, Indiana, Iowa, Kentucky, Maryland, Michigan, Minnesota, New York, Oregon, Rhode Island, Texas, Vermont, and Washington state, the AP reported.

The foundation offered a key footnote to its early warning about spikes in the cost of health coverage, which for several years now had remained low:

billpaying-150x150While Congress seems paralyzed or, at best, willing to shrink significantly its efforts to help Americans deal with the punishing costs of care in the U.S. medical system, could federal lawmakers be confronted at the same time with more compelling evidence about the need for aggressive, not timid, action?

Do beleaguered constituents need to barrage members of the House and Senate with copies of an excellent, painful series from NPR and the nonpartisan Kaiser Health News service on the crushing effects of medical debt on regular folks, especially cancer patients? Must voters write, call, and email  representatives to ensure they see the research findings of the Kaiser Family Foundation or the Commonwealth Fund about how nightmarish the U.S. medical system has become?

In detailing the “financial toxicity” that cancer patients experience with bankrupting treatment, KHN reporter Noam Levey mixes poignant human stories with scary economic data to detail how care for a leading killer of Americans may have improved medically but has become a calamity of a different sort. He makes these points among others (quoted liberally but without their sourcing, not fully included in these bullets for brevity’s sake):

apachedash-300x177Anyone who has so much as contemplated buying a vehicle in recent times will quickly catch on to what experts fear may be a root cause of the nation’s spiking road toll: Step back and consider just how much importance manufacturers — and consumers — pay to those rolling infotainment systems.

Their screens have grown and dominate the dash. They no longer just control a tinny AM radio. They’re the gateway to powerful and all-encompassing entertainment systems. These can deliver high-fidelity music of all varieties, sports contests, news, and political commentary, as well as digital visual content viewable by passengers. The touchpad systems regulate the heat, air conditioning, and interior lighting. They also display ever-more sophisticated navigation, with dizzying maps, road and traffic conditions and warnings, as well as audio narratives of directions and even route highlights.

And what motorist now doesn’t have her cellphone linked into the “smart” vehicle system. This means dozens of contacts can be reached via conversation with a digital assistant, who then can hook a motorist up with the office, boss, spouse or partner, kids — and who knows who else? Combine this all, of course, with other driver displays — including speed, RPM, fuel consumption and conservation, engine temperature, and more.

kneeinjectionSince the 1970s, some doctors have treated arthritic knees by injecting them with hyaluronic acid, a substance originally derived from the combs of roosters. Specialists have zealously promoted this therapy, costing patients a few hundred dollars a pop and repeated so widely that Medicare alone pays $300 million annually for it. Doctors argue it reduces pain and increases joint mobility.

It hardly lives up to this billing, though, offering patients scant more relief than a placebo (saline, or salt water), researchers found after scrutinizing a half century’s worth of data from 169 clinical trials involving more than 20,000 patients.

The highly popular viscosupplementation procedure, as reported by Stat, a medical and scientific news site, showed an average effect “about 2 points beyond placebo effect on a pain scale that runs from 1 to 100.” The researchers from Canada, Britain, and China concluded this from their study, as published in BMJ, a respected medical journal of the British Medical Association:

dive-180x300Even as Congress lumbers into creating the next crisis for millions of Americans and whether they can access and afford health insurance, the giant, built-in flaws in the current coverage system keep sending far too many patients and their loved ones into a financial morass with which politicians and policymakers refuse to reckon.

Successive Democratic and Republican administrations have clashed over health insurance, notably the coverage extended to poor, working poor, and middle-class folks under Obamacare. But the people in charge have erred, big time, by blindly accepting a health care fallacy that plagues the U.S. system, according to Aaron E. Carroll,  the chief health officer for and a distinguished professor of pediatrics at Indiana University. He said this in a New York Times Opinion article:

“The Affordable Care Act was supposed to improve access to health insurance, and it did. It reduced the number of Americans who were uninsured through the Medicaid expansion and the creation of the health insurance marketplaces. Unfortunately, it has not done enough to protect people from rising out-of-pocket expenses in the form of deductibles, co-pays, and co-insurance. Out-of-pocket expenses exist for a reason; people are less likely to spend their own money than an insurance company’s money, and these expenses are supposed to make patients stop and think before they get needless care. But this moral-hazard argument assumes that patients are rational consumers, and it assumes that cost-sharing in the form of deductibles and co-pays makes them better shoppers. Research shows this is not the case. Instead, extra costs result in patients not seeking any care, even if they need it.

MLSlogo-150x150In 2015, public attention galvanized around the significant risks of head trauma and the sport of football with the disclosure that Andre Waters, 44, a hard-hitting, onetime Philadelphia Eagles player, had been diagnosed after his suicide with chronic traumatic encephalopathy, or CTE.

Has soccer — one of the most popular pastimes on the planet and a dominant game of U.S. suburban life — also hit its day of reckoning for head injuries? The issue has been brought to the fore with the revelations that Scott Vermillion, 44, a onetime soccer pro, has been posthumously diagnosed with CTE, the degenerative brain disease “linked to symptoms like memory loss, depression and aggressive or impulsive behavior,” the New York Times reported, adding:

“The diagnosis gave Vermillion the grave distinction of being the first American professional soccer player with a public case of CTE. It was a solemn milestone, too, for MLS, a league that has, even in its young history, seen the consequences of the type of brain injuries more commonly associated with collision sports like football, boxing and hockey. For soccer as a whole, the finding will add another note to a small but growing chorus of concern about the health risks of playing the world’s most popular game. ‘Soccer is clearly a risk for CTE — not as much as football, but clearly a risk,’ said Dr. Ann McKee, the director of the CTE Center at Boston University.”

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