Republicans who vote/voted for AHCA earned the enmity of parents like Natalie Weaver

Good luck with that. These moms aren’t going anywhere.

More on Health Policy Considerations

Today’s New York Times has an op-ed piece extolling some of the virtues of the Republican plan for health insurance; one take-away from it (featured by the NYT) is that “5 percent of Americans generate more than 50 percent of health care expenses.”

So what? Before I retired in 2002, my medical expenses were minimal. Since then, however, I have had  a number of medical problems. In other words, the smug feeling I used to have about others who populated the health care system has given way to the reality of (what I should have known, as a statistically savvy person) the difference between cross-sectional and longitudinal analyses. Cross-sectionally, 50 percent is pretty scary, unless you realize that that 50 percent is primarily populated by the likes (and age) of me. Longitudinally, however, the data may show a different story, with perhaps 10 percent of the population never having major problems throughout their life, and have paid (as insurance should) for the difficulties that they luckily never experienced.

The author of the op-ed noted that his 93-year-old father “just received a $50,000 catheter-inserted aortic valve, which was covered by Medicare.” Is he suggesting that his father should have just sucked it up and lived in pain or in a wheelchair for the next few years of his life? Doesn’t he realize that Medicare is just what he recommends, that his father and those like him are using Medicare to “save their own money for just this sort of rainy day,” with the proviso that we may not all need that umbrella? Insurance, whether for cars or homes or health, is meant to spread the risk.

“If your baby is going to die, and it doesn’t have to, it shouldn’t matter how much money you make”

+1000 to Jimmy Kimmel.

Before 2014, if you were born with congenital heart disease, like my son was, there was a good chance you’d never be able to get health insurance because you had a preexisting condition…

If your parents didn’t have medical insurance, you might not live long enough to even get denied because of a preexisting condition. Babies shouldn’t die when surgery can save them.. It shouldn’t matter how much money you make.

His comments on health reform and preexisting conditions are here. His newborn son’s heartwarming story is below. My favorite line is simple: “We need to take care of each other.”

Two caveats to a touching photo-op

Speaker Ryan’s bill would allow states to waive ACA protections that now bar insurers from charging higher premiums to childhood cancer survivors. It would also allow states to weaken the Essential Health Benefit, which is so critical to ensure that insurance actually works for people who experience costly or life-altering conditions.

I haven’t even gotten to Medicaid and the impact of higher premiums for low-income people.

Facebook statement of Dr. Vivek Murthy, dismissed yesterday as U.S. Surgeon General

Dr. Vivek Murthy, speaking at his confirmation, December 2014

Dr. Vivek Murthy was dismissed from his position yesterday as U.S. Surgeon General. He and I have been friends for a long time. Although I knew this moment might come, it remains bittersweet for me, as it surely is for so many others.

My regrets go beyond the personal. Dr. Murthy is pursuing an important agenda to improve population health. I hope that his successor can continue this important work, which should command bipartisan support in a polarized time. He is an exemplary role model for others at high levels of leadership in American public life.

Dr. Murthy released a statement on Facebook. I reproduce it below the fold. It expresses the dedication, reflectiveness, and generosity of spirit he brings to his life and work.

Thank you for your service to the nation, my friend. I can’t wait to see what you will do next.

Continue reading “Facebook statement of Dr. Vivek Murthy, dismissed yesterday as U.S. Surgeon General”

NAS Studies and President Trump’s Address

I received this post from a friend:

This morning I received an email from the National Academies Press (see the URL, below) containing both the script of President Trump’s recent Joint Address to Congress and — interspersed at relevant locations — copies of various NRC reports from the National Academies containing information, data and recommendations about the many scientific, engineering and medical issues facing our country (and the world).

This is a perfect representation of the Academies’ primary mission — to serve the federal government by bringing unbiased (and carefully refereed) technical and analytical expertise and results to the nation’s decision-makers.  I thought you, and friends and colleagues, might be interested in this document.  Feel free to forward it to all and any.

Filthy Lucre

I took it as a small sign of the decline of Western Civilization when Boodles stopped boiling coins before putting them in the change drawer at the bar. Many people are careful about not acquiring and transmitting illness in many respects, but few of us seem to consider how the handling and transfer of money could contribute to it.

Some criminologists are examining the impact of the increasing rarity of physical currency on crime: Muggings are less profitable and hence rarer; on line thefts are more common because increasingly “that’s where they keep the money”, as Sutton is said to have said. Inspired by the criminology research in this area, I would like analogous studies conducted regarding the incidence of influenza during the peak season in places where contactless cash cards are replacing paper and metal dosh.

I contemplate this more than most people because I often eat in the two medical centers with which I am affiliated. Think about a hospital cafeteria: All day long people who are sick or have been visiting or treating sick people fumble through their currency and coins with bare hands and then give some money to the cashier, usually getting change in return that was handled by a previous customer. This happens hundreds of times an hour at some times of day, and then of course everyone sits down to eat, usually without washing their hands post-lollyhandling.

Thought experiment: Randomly convert 50 hospital cafeterias to cashless transactions and compare the infectious diseases rate to 50 hospitals where bacteria-ridden physical cash is still in fashion. I don’t know if the effect would be large enough to be seen at the hospital level, but I’d like to see an investigator evaluate the possibility.