Disclosure

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 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 3, 2019

As doctors warned UNC about heart surgery program, kids kept dying

by Patrick A. Malone

Although big hospitals may love to pat themselves on the back and boost their profits and professional standings by claiming to offer “comprehensive” services, children may suffer and die due to the reality versus the hubris of institutions’ excessive initiatives with specialized care.

Officials at the University of North Carolina blew past anguished warnings from their own pediatric cardiology staff of significant problems in the pediatric heart surgery program at the medical center’s children’s hospital, the New York Times reported. Brushing aside their concerns about a lack of resources within and to support the program, UNC declined to make public, as most similar specialty efforts do, key performance measures. They would show that the UNC pediatric heart surgery program had a higher death rate than “nearly all 82 institutions that do publicly report” this and other measures of patient care.

The newspaper, in a rare move, has internal tape recordings of doctors disputing among themselves whether dwindling resources, staff departures, and other problems meant that UNC should do what many of the specialists demanded — take a long hard look at what was going wrong, and, in the meantime, refer sick kids to other institutions to safeguard their care.

May 31, 2019

FDA’s dubious oversight of heart devices: hidden complaints and shaky tests

by Patrick A. Malone

Cardiac patients may wish to take to heart how news reports have undercut federal regulators’ claims that they provide the most rigorous oversight to medical devices that treat complex conditions in ways that pose the greatest risk. With certain heart pumps and defibrillator units, both implanted in patients, the Federal Food and Drug Administration deserves criticism for putting the interests of device makers ahead of patients, excellent stories by the Kaiser Health News Service and Axios show.

KHN reporter Christina Jewett followed up her investigation into how FDA bureaucrats let device makers file 1.1 million reports of injuries or malfunctions with their products to a little-known internal agency database, discovering how this practice contributed to what one cardiologist described as “the worst cardiac device problem” he has seen in a quarter-century of practice.

The incidents involved the Sprint Fidelis, a small device surgically installed in hundreds of thousands of patients to monitor and supposedly to administer small shocks to deal with their irregular heartbeat. Instead, the device — especially due to problems with its corroding and cracking electrical leads — gave patients random jolts, failed to perform in genuine emergencies, and led to a torrent of complaints and deaths. Doctors, medical researchers, and patients forced into wide public view the substantial defects of the defibrillator, including in congressional hearings.

May 23, 2019

Generic drugs ensnared in price-fixing and shoddy manufacturing claims

by Patrick A. Malone

With Big Pharma pressing the limits in promoting and pricing prescription medications, patients and their advocates long have hoped that generic drugs might be difference-makers on costs and practices. Those positive wishes, however, may be dying out by the day.

The attorneys general of dozens of states have sued major generic makers including Teva, Pfizer, Novartis and Mylan, accusing them of conspiring to inflate generic drug prices by as much as 1,000%, the New York Times and other media organizations reported.

The makers’ price-fixing affected more than 100 generics, including “lamivudine-zidovudine, which treats H.I.V.; budesonide, an asthma medication; fenofibrate, which treats high cholesterol; amphetamine-dextroamphetamine for A.D.H.D.; oral antibiotics; blood thinners; cancer drugs; contraceptives; and antidepressants,” the New York Times said.

May 7, 2019

Did FDA just let Big Tobacco put another burn on Americans’ health?

by Patrick A. Malone

Federal regulators appear to be getting caught flat-footed yet again as Big Tobacco’s harms metastasize before their very eyes. The federal Food and Drug Administration has given a qualified go-ahead to Philip Morris International to sell a device that heats but does not burn tobacco, a process that appears to expose users to fewer harmful toxins.

Still, the iQOS gadget packs the same wallop of highly addictive nicotine as does a standard, tobacco-burning cigarette. And the FDA decided it would be regulated just as cigarettes are, thereby restricting its sales and marketing to young people.

Big Tobacco executives talked up iQOS (eye-kos) as yet another way for smokers of their proven and deadly burned tobacco cigarettes to get unhooked from them and to lessen their health harms.

May 3, 2019

Climate change is worsening air quality, allergies, and Americans’ health

by Patrick A. Malone

If residents of the nation’s capital aren’t already sneezing, hacking, and swiping at red and rheumy eyes, just wait — the spring allergy season is upon us. And it may be longer and worse than ever. Then, Washingtonians also may be gasping soon for another reason: worsening air pollution, specifically problematic ozone levels in summer heat.

Though science deniers may be resisting environmental realities, human-caused climate change already is affecting our health and well-being.

Air pollution, for example, is a rising worry, the American Lung Association reported in its 20^th annual report on clean air. The health group advised that:

April 29, 2019

Measles outbreaks increase, with cases hitting highest level since 2000

by Patrick A. Malone

Almost two decades after public health officials declared them eradicated from this nation’s children, measles infections have returned with a vengeance to the United States, rising to the highest level in almost two decades, with hundreds of cases in almost two dozen states, and the incidences climbing still.

The outbreaks have been concentrated in New York, in Brooklyn in a religious community, and in Washington state. But authorities have taken aggressive steps, including quarantine orders for hundreds of students and staff on two big college campuses across town from each other (UCLA and Cal State, LA), to ensure that the disease is contained and does not spread in Los Angeles.

Alex Azar, who heads the federal Health and Human Services Department, said in a statement about the familiar infection: “Measles is not a harmless childhood illness, but a highly contagious, potentially life-threatening disease. We have the ability to safely protect our children and our communities. Vaccines are a safe, highly effective public health solution that can prevent this disease. The measles vaccines are among the most extensively studied medical products we have, and their safety has been firmly established over many years in some of the largest vaccine studies ever undertaken.”

April 23, 2019

Ph.D. turns to Twitter to rat out too common species of medical research hype

by Patrick A. Malone

James Heathers is a Ph.D. with expertise in scientific methods and data. He works in a behavioral science lab at Northeastern University in Boston. He’s young, adaptive, and savvy enough to participate in social media, especially Twitter. There, he saw a problem and a challenge with the way medical scientific findings get presented to sizable audiences online.

As someone accustomed to dealing with academic and scientific rigor, he paused and thought he could title his planned effort, “handling the translational gap during the science media transition.” But this Aussie has a sense of humor—and he wanted impact. He thought a straight-laced approach would be as “popular as cabbage sandwiches.”

So, instead, he focused in on a broad number of reputable studies that he thinks get misrepresented and grab unjustified popular attention. This research involves the extrapolation of early results in animal tests, making them sound — incorrectly — as if they instantly have meaning for people. He created a Twitter account that is garnering lots of attention, including tens of thousands of unexpected followers.