Research Studies

February 13, 2020

A top U.S. health official can’t get his. Which is why we need records reforms.

Federal regulators may be on the brink of not only protecting but also advancing patients access and use of a key component of their care: their electronic health records. Or will bureaucrats fold up in the face of a muscle campaign by corporate interests and hospitals?

To its credit, the giant Health and Human Services agency has emphasized that it is moving forward in its announced plans to prepare new regulations on so-called EHRs, pressing patients’ rights and newer, and potentially more nimble tech firms’ abilities to make the information in the records more accessible and helpful.

But Epic, the giant software company that has installed electronic systems in hospitals and health systems nationwide — often for billions of dollars — is leading resistance to the new rules. It has convinced dozens of institutions and groups, some sizable, to lobby officials to oppose this federal intervention.

February 11, 2020

Crucial doctor-patient relationships showing distressing signs of fraying

by Patrick A. Malone

Although health policy experts and doctors themselves may sing the praises of primary care providers — medical generalists who are supposed to be the first and important caregivers for most patients — recent studies suggest that yet another idealized aspect of the U.S. health care system has cost- and access-driven problems.

Patients, to start with, are driving a concerning trend in which they in increasing numbers are declining to tap the services of family doctors and other so-called PCPs.

Doctors in this field, as well as others, say that patients may be turning to online consultations, urgent care centers in drug stores and shopping malls, or more costly visits to highly credentialed specialists due to the spiking pressure on frontline MDs to maximize revenues by minimizing their “face time.” Physicians describe how “bean counting” executives in health systems may require them to see more than a dozen patients a day, while also handling all the bureaucracy, consultation, research this requires — or face sizable pay cuts for their “inefficiency.”

February 9, 2020

As coronavirus pummels China, concern rises about U.S. health care supplies

by Patrick A. Malone

The toll of the coronavirus outbreak in China keeps worsening, with the infections exceeding tens of thousands and the deaths spiking toward 1,000, also claiming the first American and Japanese lives of people in the disease epicenter of Wuhan.

The illness’ most significant harms continue to afflict China, particularly its central province of Hubei and regional capital Wuhan.

But the infection has raised global alarms, in part because its death toll, for example, has far exceeded in China the fatalities recorded with the 2003 disease incident involving Severe Acute Respiratory Syndrome, or SARS. That infection killed hundreds in China.

February 6, 2020

With U.S. health care costs sky-high, why gouge programs to help vulnerable?

by Patrick A. Malone

If rigorous research drove policy making in a more optimal fashion than it now apparently does, how might politicians and regulators react to findings like these:

The well-respected Commonwealth Fund has revisited earlier studies, finding anew that the United States “spends more on health care as a share of the economy — nearly twice as much as the average [industrialized Western European] country — yet has the lowest life expectancy and highest suicide rates among the 11 nations. The U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the average [in comparable Western industrialized and European countries.] Americans had fewer physician visits than peers in most countries, which may be related to a low supply of physicians in the U.S. Americans use some expensive technologies, such as MRIs, and specialized procedures, such as hip replacements, more often than our peers. Compared to peer nations, the U.S. has among the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths.”

Even while spending more than any other nation on health care and getting poorer outcomes, which Americans bear the heaviest burdens of the system’s costs? Here’s what researchers at the nonpartisan and independent RAND Corporation have found in a newly published study:

January 31, 2020

Here’s why the U.S. surgeon general and WHO want smokers to quit, asap

by Patrick A. Malone

Cigarette smokers got yet more chiding from public health officials about why and how they should quit an addictive and destructive habit. To do so isn’t easy, and a “shocking” number of doctors aren’t helping enough, the Surgeon General of the United States conceded. But there are big reasons to give up the nasty vice, especially before elective surgery, the World Health Organization warned.

The health experts found much to agree on when it comes to the carnage smoking causes. As the New York Times reported on the surgeon general’s work:

“More than 55 years after the first surgeon general’s report warned that smoking causes cancer, it remains the leading cause of preventable death and disease in the United States. According to the Centers for Disease Control and Prevention, the rate of smoking in the United States has declined to an all-time low of 14%. More than 3 of every 5 adult Americans who have smoked have quit, the report said. Still, 34 million Americans currently smoke, and an estimated 480,000 die from smoking-related illnesses each year, the agency said. About 16 million people in the United States now suffer from cancer, heart disease and smoking-related disorders, according to the CDC. The financial toll is enormous too, with annual health care spending attributed to smoking exceeding $170 billion, the agency said.”

January 28, 2020

California, Big Blues, and hospitals join the attack on sky-high drug prices

by Patrick A. Malone

Big Pharma, with its relentless price gouging, may finally have poked in the eye the wrong people. But even as patients wait to see if hospitals, and now states and insurers, can beat down skyrocketing drug prices, isn’t it past time for more public shaming for doctors who persist in writing excessive, dubious, and downright risky prescriptions?

Although the Trump Administration and Republicans in Congress have failed to deliver on repeated promises to attack excessive costs for prescription drugs, the state of California and now leading insurers are following some hospitals in tackling the problem.

Calif. Gov. Gavin Newsom (shown, above right), in unveiling his state budget, told lawmakers that he wants the Golden State to consider contracting with generic drug makers to produce products that would cost less and be sold under a California label. As the Los Angeles Times described the still-to-be fleshed out gubernatorial plan:

January 24, 2020

While policy makers engage in food fights, kids are getting fed dubious eats

by Patrick A. Malone

Will grownups in the room step up soon and stop the nonsense? Or should consumers, especially parents and those who want to eat in healthful ways, just expect a perpetual food fight about what’s good and reasonable for Americans, especially our kids, to eat?

When it comes to breakfasts and lunches served to 30 million youngsters at 99,000 schools, the U.S. Department of Agriculture, long a standard-setter on dietary matters, has put itself in a head-scratching position.

That’s because the agency backed away from strict nutritional standards, saying it will relax the amounts of fruits and vegetables that schools provide kids under the agency’s Food and Nutrition Service guidelines. Instead, institutions would be permitted to sling more burgers, fries, and pizza, likely increasing youngsters’ consumption of high calories, saturated fats, and sodium.

January 23, 2020

Yes, you may suffer heart disease, even in the most fitness-fanatical state of the union

by Patrick A. Malone

Sure, it can be fun to watch two East Coasters take a long, sharp pin and pop the fantasy bubble that Westerners, especially Coloradans, like to float around in. Mountain state residents may like to tell themselves how the people on the Front Range skew young, educated, and active. How blue skies and open spaces keep folks busy and outdoors. And did they mention super healthy?

Or maybe not.

There’s a bigger takeaway in the recent focus on the Rockies by reporters Betsy McKay and Paul Overberg. As the Wall Street Journal duo found:

January 21, 2020

FDA reviews go faster — but with less proof drugs are safer or more effective

by Patrick A. Malone

For anyone concerned with the quality and safety of prescription medications, this may be an especially displeasing commentary from a pharmaceutical expert about drugs raced to approval now: “Some of them are really great,” the professor observed. “And some of them [are] not so great. And a lot of them are very expensive.”

That quote, by the way, comes from a news report by NPR on so-called reforms of the federal Food Drug and Administration prescription drug oversight process. Big Pharma has howled for some time now at politicians, regulators, and the public for fixes to the system — and the industry has gotten its way.

Now, as NPR reported, based on a new study posted online on the JAMA Network:

January 16, 2020

Spiking death rate a harsh reminder of alcohol’s risks, especially for women

by Patrick A. Malone

Tipple much, much less in 2020. That might be a life-saving bit of advice for too many Americans to follow, especially because of new data on a worrisome spike in alcohol-related deaths.

As NBC News reported, based on published research by federal researchers:

“The yearly total of alcohol-related deaths for people ages 16 and over more than doubled, from 35,914 in 1999 to 72,558 in 2017. There were almost 1 million such deaths overall in that time. While middle-age men accounted for the majority of those deaths, women — especially white women — are catching up, the study found. That’s concerning in part because women’s bodies tend to be more susceptible to the effects of alcohol.”