Health Policy

Clearly, I'm not the only one who thinks that the most obvious solution for health care reform is for the House to pass the Senate bill: The New York Times just published an editorial arguing the same point: The most promising path forward would be for House Democrats to pass the Senate bill as is and send it to the president for his signature. That would allow the administration and Congress to pivot immediately to job creation and other economic issues. The Senate bill is not perfect, but it would expand coverage to 94 percent of all citizens and legal residents by 2019, reduce the deficit…
It's been a rocky ride this year, getting heath care bills passed in the House and the Senate. It's been just over a month since the Senate passed its bill in a dramatic Christmas Eve vote (and much longer since the House passed its version), but the fate of health care reform still appears as uncertain as ever. In particular, a surprising political setback in Massachusetts has made the already difficult Senate an almost impossibly hostile environment for reform. The most obvious solution is for the House to pass the Senate bill without hesitation; however, House Speaker Nancy Pelosi has…
Yesterday, the influential AMA (American Medical Association) announced that it would cease its opposition to the concept of medical marijuana and instead advocate for a change in federal classification of the drug. From the LA Times: The American Medical Assn. on Tuesday urged the federal government to reconsider its classification of marijuana as a dangerous drug with no accepted medical use, a significant shift that puts the prestigious group behind calls for more research. The nation's largest physicians organization, with about 250,000 member doctors, the AMA has maintained since 1997…
I recently had the pleasure of writing an op-ed piece about health care reform for my hometown newspaper, the Fort Worth Star-Telegram, and it ran in the paper today. You can check it out online here. I grew up reading the Star-Telegram, so this was an exciting opportunity. My article discusses the need for robust health care reform in the form of a strong public option, comparing and contrasting my health care experiences in the US and the UK to build my case. For regular readers of my blog, you will note that this is a theme I have often explored. I would have preferred that the Star-…
I'm sorry, I'm afraid that title's misleading. This is actually an early video of UnitedHealth CEO Stephen J. Hemsley (whose salary is estimated at $102,000 an hour) discussing his principled stance on why he's opposed to the public option in US health care reform. Or it could be The Money Song from Monty Python's Flying Circus. It's difficult to tell them apart.
Mike Dunford tells a compelling story today at The Questionable Authority: Yesterday, I took the kids to the doctor for their school physicals. I wouldn't normally subject you to an account of the day-to-day minutia of my personal life, but given the current debate about how we should handle health care in the United States, the details might be of interest. We arrived - without an appointment - at a medical facility that we had not been to before. We did not have medical records with us, and the only paperwork of any kind that we had brought were the forms that needed to be filled out to…
Mark Hemingway, the Conservative "tough-guy" for the National Review, has just posted a rant against health concerns for the endocrine disruptor Bisphenol A. I've seen some estimates that over a billion people have had exposure to BPA and there isn't proof of anything. So why the big scare? I assume trial lawyers are involved in the fear mongering. That's a given. But then I saw that last year two reporters from the Milwaukee-Journal Sentinel won a George Polk Award-- a major journalism honor -- for reporting on the "dangers" of BPA. It's another reminder that there are some perverse…
Yesterday, the Institute of Medicine released a report entitled "Conflict of Interest in Medical Research, Education, and Practice". As far as I can tell, the full report is only available for a fairly substantial charge, but these are some of the main recommendations summed up in the report's press release: All academic medical centers, journals, professional societies, and other entities engaged in health research, education, clinical care, and development of practice guidelines should establish or strengthen conflict-of-interest policies, the report says. Disclosure by physicians and…
Further to the points I wrote about in my previous post on the CIA torture memos, Mike Dunford of The Questionable Authority has previously raised another important issue: the complicity of medical professionals in CIA torture: Reading these memos, it's very clear that there are quite a few CIA employees who are allegedly medical professionals. Those people need to find new professions. I would strongly suggest that you take a few minutes - particularly if you're a doctor or a psychologist - to suggest to your colleagues at the American Medical Association and the American Psychological…
As mentioned here previously, the stimulus package passed in February includes funds to encourage evidence-based medicine. Some uninformed critics will claim that this is some big government conspiracy to exert socialized control over private medicine. But, truly, encouraging a firmer empirical basis in all aspects of medicine--through more studies, government guidelines, and just improved common practice--is a very desirable outcome. A post by David Newman at The New York Time's Well blog lays out a variety of examples of why this is so (with links to original studies!). Also, Hugh Pickens…
You see, this is why you want to fill your administration with smart, qualified, thoughtful, and innovative people--especially in the sciences. From The Times A major investment in fighting tropical infections and chronic conditions like heart disease and diabetes in poor countries would transform international perceptions of the US, according to Harold Varmus, who co-chairs the President's Council of Advisers on Science and Technology. In an exclusive interview with The Times, Dr Varmus said that American diplomacy had undervalued the role of medicine and science in fostering friendly…
What can I even say about this? From the Austin American-Statesman: At a hearing Thursday of the House Committee on Human Services, [Texas State Representative Gary] Elkins and other members of the panel considered more than two dozen bills related to Medicaid and the Children's Health Insurance Program. Three hours into the hearing, Elkins asked: "What's Medicaid?" The Houston Republican continued: "I know I hear it -- I really don't know what it is. I know that's a big shock to everybody here in the audience, OK." And, for the win.... Medicaid, for the record, is the federal-state health…
An article in today's New York Times profiles the trials and tribulations of young twenty-somethings who lack health insurance. For some it's out of hubris, but for most it's because they fall through the cracks--paid enough that they don't qualify for public health care but still lacking the means to afford health insurance of their own. It's pretty sad, and it's a stupid result of America's wacky health care system (a system around which many high hopes have been pinned to President Obama to effect some real change). As stupid as this situation is, though, it pales in comparison to the…
As part of the stimulus package passed by Congress last Friday (H.R. 1: American Recovery and Reinvestment Act of 2009), the US will be ramping up efforts to encourage evidence-based medicine. This is a very good thing. Specifically (from The New York Times): The $787 billion economic stimulus bill approved by Congress will, for the first time, provide substantial amounts of money for the federal government to compare the effectiveness of different treatments for the same illness. Under the legislation, researchers will receive $1.1 billion to compare drugs, medical devices, surgery and…
I was excited when I saw that The New England Journal of Medicine had today published summaries by Obama and McCain of their health care plans, expecting something quite detailed to appeal to a highly critical expert audience. However, their summaries were still as general and vague as ever. Regardless, these new write-ups are still a nice resource for people interested in the two candidates' plans. You can read Obama's plan here, McCain's here, or see a pdf of both side-by-side here. On many aspects, both plans--at least as they're presented here--are quite similar. Both stress…
When I think back to the presidential debate last night, one moment stands out in my mind more than any other. And, no, it wasn't McCain calling Obama "that one". It was the discussion following Tom Brokaw's question "Is health care in America a privilege, a right, or a responsibility?" Health care came up several times throughout the debate, but here I thought the answers were most telling. This is in spite of the fact that I took issue with the way the question was phrased. Specifically, I felt that the third choice ("responsibility") was unnecessary and just gave the candidates an easy…
Last night was a historic night, with Barack Obama finally effectively clinching the Democratic nomination by surpassing the "magic number" of required delegates. Barring any last-minute fight over delegate rules from Hillary Clinton's campaign (something that I think is not likely to happen), Barack Obama in the Democrats' nominee. Of course, we knew from the beginning that 2008 was going to be a trailblazing election--we just didn't know which way it would swing. Although it's been pretty clear since Obama's string of victories in February that he would eventually be the nominee, now it'…
Last Thursday (April 24), the Senate unanimously passed the Genetic Information Nondiscrimination Act of 2008 (GINA, H.R. 493) in a landmark vote. The goal of this bill is "to prohibit discrimination on the basis of genetic information with respect to health insurance and employment," and it therefore would help fill this gaping hole that exists in our current protection of employees' and patients' rights. The bill was passed by the House roughly one year ago by a vote of 420-3, and although it was scheduled for debate in the Senate, it wasn't voted upon until last week. Now, the Senate has…
It's difficult to find too many substantive policy differences between Barack Obama and Hillary Clinton (especially considering the much larger gulf that exists between them and the Republican candidates), but one area that's brought up time and time again is health care. In light of this, it's worth taking a look at how much the two agree and disagree here, especially since health care policy is purportedly one of Clinton's selling points. To look at the actual plans from each of the candidates, you can click here for Obama's and here for Clinton's. The most thorough--but still accessible…
A few interesting items have recently come up in the news and in the scientific literature about various methods for preventing the transmission of HIV. First up is a study (1) published in PLoS Medicine this week that demonstrated the effectiveness of a combination of antiretroviral drugs in preventing viral transmission in a monkey model of HIV. The researchers demonstrated that taking the antiretroviral drug emtricitabine (FTC) orally could reduce the chance that a macaque would become infected. Adding tenofovir-disoproxil fumarate (TDF) increased protection, and injecting both drugs (…