- Can President Trump keep up his barrage of counter-factual assertions and political reverses on federal help for those needing health insurance, a key part of the Affordable Care Act? After resurrecting in federal courts the decade-long debacle of Republican efforts to kill Obamacare—including its protections for preexisting conditions—Trump flipped yet again. He heard an earful from party leaders that they have no way to cover tens of millions who would lose their health insurance if the ACA gets tossed out by courts, and he apparently awoke to the reality that the GOP can’t eliminate the law when Democrats control the House. So, the president then insisted that the GOP, after failing to do so for years, would present a better alternative and enact it, repealing Obamacare, too—at some time after the 2020 elections. If Republicans win back the House, keep control of the Senate, and he is reelected.
- Even as the president asserted the GOP’s superiority in health care policy, the Los Angeles Times and the Philadelphia Inquire reported that a key element of Trumpcare is bringing back consumer nightmares. Patients initially might like the short-term health insurance plans the administration has pushed as an ACA alternative. Officials have relaxed rules on them so they can last longer than the few months permitted under Obamacare. The plans may carry lower monthly premiums. But they come with skimpy benefits. Which consumers are rediscovering. They’re getting sick and hoping to rely on short-term policies, only to find they owe doctors and hospitals thousands of dollars—but their insurance won’t help them with a penny.
Americans have real reason to fear a health care catastrophe: If loved ones suffer major injury or illness, who will feed, bathe, and care for them 24/7 after they get out of the hospital and recuperate at home? Who will take time off from work to set up and take them to unending and long medical appointments? Who will wait for and get all the pills and devices they need?
The nation has been locked in a decade-long battle over health insurance that helps cover medical costs, but caregiving, a crucial part of the social safety net, gets short shrift, writes Aaron E. Carroll, a professor of pediatrics and health research and policy expert at Indiana University School of Medicine. As Carroll noted in a timely and personal column for the New York Times “Upshot” feature:
Americans spend so much time debating so many aspects of health care, including insurance and access. Almost none of that covers the actual impossibility and hardship faced by the many millions of friends and family members who are caregivers. It’s hugely disrupting and expensive. There’s no system for it. It’s a gaping hole.
Although lawsuits can result in needed financial support and welcome recognition of harms suffered by patients seeking medical services, the civil justice system has its limits. They showed in cases in the news in which disputing parties agreed to more than $1 billion in resolutions that left issues unanswered.
What to make of the:
- $270-million that Purdue Pharmaceutical will pay to end its part of a fight with Oklahoma over the opioids crisis that has killed hundreds of thousands of Americans
Uncle Sam has paid what critics have called long overdue attention to women’s breasts and how surgeons and diagnosticians treat them.
In an angry and emotional public hearing, women ripped the federal Food and Drug Administration for lax oversight of implants that surgeons use to augment and reconstruct breasts, even as the agency proposed its first changes in 15 years to guidelines about mammograms for patients with dense breast tissue.
The FDA has been under fire for decades over breast implants, mostly banned in 1992 but allowed anew in 2005. Experts long have debated whether materials in the implants, notably silicone and not necessarily saline fillings, may be injurious to women’s health. New concerns have developed over surface texturing on the devices, which are supposed to help in the surgery but may affect tissues around and near the breast, leading to spikes in reported cases of rare cancers.
Doctors, hospitals, and their malpractice insurers like to demonize lawsuits brought by injured patients, but these legal actions provide a powerful way to identify problem practitioners, and the medical profession should see this truth and use it to better police its own ranks.
That’s one of the recommendations from medical-legal researchers at Stanford University, who examined more than a decade of 60,000 payments for malpractice claims against more than 50,000 doctors. They found a tiny slice of doctors rack up a disproportionate share of repeated malpractice claims. They describe these MDs as “frequent flyers,” a term familiar to the medical community because it often is applied to indigent and homeless patients who rack up big bills for repeated emergency room visits.
Profs. David Studdert and Michelle Melloound found that 2% of physicians accounted for 40% of the paid malpractice claims over a 13-year period. Further, in the report of their study in the New England Journal of Medicine, they offered details on doctors who lose, and keep losing, malpractice cases due to problem care:
After persuading as many as 7 in 10 American adults to take a daily low dose of a common painkiller to protect against heart disease and cancer, experts now say it is time for more nuanced advice on who should and who shouldn’t take the daily baby aspirin regimen.
Recent studies have shown that the believed protective benefits of low-dose aspirin need to be balanced against the risks of bleeding caused by the drug, the American Heart Association and the American College of Cardiology have declared.
Here is who should NOT go on low-dose daily aspirin:
Doctors and hospitals finally are owning up to and treating mental and physical damages inflicted on some of the sickest and most vulnerable individuals in their care—the 5 million or so patients who get helped in intensive care units, published research shows.
Although ICU patients may get dramatic emergency care that saves them from deadly infections, major disease, and significant accident or injury, experts only recently have begun to recognize and assist them with a condition associated with their stays: post-intensive care syndrome (PICS). A readable new study in the medical journal JAMA says that ICU patients may suffer a “constellation of symptoms” with PICS that hinders their recovery to their pre-hospitalization well-being, including: “muscle weakness, cognitive impairment, depression, anxiety, and post-traumatic stress disorder (PTSD).”
As doctors and public health officials coast-to-coast battle infectious outbreaks — of measles, mumps, meningitis, whooping cough, influenza, as well as typhus, hepatitis, and TB — the nation is also struggling with the right response for yet another contagion: the viral spread of medical misinformation on social media.
Medical nonsense isn’t new, and savvy patient-consumers long have needed to do a little work to protect themselves from what can be its real and significant harms. But a season of rapidly spreading and 100% preventable infectious diseases has forced modern medicine to confront generational dilemmas with health disinformation that is “shared” widely online and especially via social media.
For the rising generation that now parents youngsters who need and should be vaccinated, social media sites like Facebook, YouTube, and Instagram, as well as information searches via Google have become as ordinary and accepted as once were daily newspapers and the 6 o’clock TV news. But cyber world’s ubiquity also has allowed counter factual, unfounded, nonscientific, and extreme notions to proliferate, as users of all kinds “create content” online. This has fueled the dangerous normalizing and further rise of the anti-vaccination or anti-vaxxer movement.
Tempting though it may be to dismiss doctors’ howls about electronic health records—maybe they’re Luddites or they’re just another group of high-paid workers beefing about their job tools—the persistent and significant nightmare of the complicated computer systems has been this: Do they harm patient care?
That’s the finding of the independent, nonpartisan Kaiser Health News Service, based on its extensive investigation in partnership with Fortune Magazine. The two media operations reported that:
- 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.