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April 17, 2014

A Fine Balance: Disability, Discrimination, and Public Safety

(The Conversation) – A recent discrimination case has highlighted the difficulty of balancing the rights of disabled medical students with the rights of the community to safe medical and health care. In the BKY v The University of Newcastle, a New South Wales tribunal found the university had discriminated against a medical student by refusing her an extension to complete the five-year medical course beyond the usual maximum of eight years.

Should Drug Firms Make Payments to Doctors?

(BBC) – Gifts and payments to US doctors from drug firms are seen by some as encouraging unnecessary prescriptions. Do such transfers make any difference and will President Obama’s healthcare reform help, by forcing companies to disclose them? Prescribe enough drugs and – as detailed in 1974 Senate hearings – a doctor could accumulate points to exchange for a wide range of consumer desirables – colour TVs, watches, microwave ovens, lawnmowers, golf clubs.

April 16, 2014

UK ‘Has Fewer Hospital Beds Per Person Than Most European Countries’

(The Guardian) – There are fewer hospital beds per person in Britain than most other European countries, with less than half the number of many, a report has found. According to the Organisation for Economic Co-operation and Development (OECD), the UK had three hospital beds per 1,000 people in 2011, with Ireland having the same number. This was far behind the majority of other countries on the continent, with Germany having 8.3 per 1,000 people, Austria 7.7, Hungary 7.2, Czech Republic 6.8 and Poland 6.6.

Event: Summer Seminar in Health Care Ethics

The Department of Bioethics & Humanities at Washington School of Medicine
27th Annual Summer Seminar in Health Care Ethics
Seattle, Washington
August 4 – 8, 2014

See here for more information.

April 15, 2014

Blood Type Influences Prostate Cancer Relapse, Study Shows

(The Telegraph) – A man’s blood group has been shown to significantly influence the chance that prostate cancer will return after successful surgery. Men with group O blood are far less likely to suffer a recurrence of the disease following surgical intervention. By contrast, men with blood group A were shown by new research to be 35% more likely to fall victim to the disease again, even after surgery.

Prices Soaring for Specialty Drugs, Researchers Find

(New York Times) – Even as the cost of prescription drugs has plummeted for many Americans, a small slice of the population is being asked to shoulder more and more of the cost of expensive treatments for diseases like cancer and hepatitis C, according to a report to be released on Tuesday by a major drug research firm. The findings echo the conclusions of two other reports released last week by major pharmacy benefit managers, which predicted that spending on so-called specialty drugs would continue to rise.

Consumers Considering Different Health Plans Find Little Info about Abortion Coverage

(Washington Post) – When it comes to coverage of abortion services in plans sold on the health insurance marketplaces, opponents and supporters of abortion rights are in agreement on one thing: Coverage details need to be clearer. A recent analysis by the Guttmacher Institute, a reproductive-health research and policy organization that supports abortion rights, found that people in some states would be hard-pressed to find any information about whether the plans they were interested in covered abortion services.

April 11, 2014

A New Edition of Health Policy and Planning is Available

Health Policy and Planning (Volume 29, No. 2, March 2014) is now available online by subscription only.

Articles include:

  • “Impact of user fees on maternal health service utilization and related health outcomes: a systematic review” by Susie Dzakpasu, Timothy Powell-Jackson, and Oona M.R. Campbell
  • “Estimates of performance in the rate of decline of under-five mortality for 113 low- and middle-income countries, 1970–2010” by Stéphane Verguet and Dean T. Jamison
  • “Financial protection in health in Turkey: the effects of the Health Transformation Programme” by Mahmut S Yardim, Nesrin Cilingiroglu, and Nazan Yardim
  • “Health reform and out-of-pocket payments: lessons from China” by Lufa Zhang and Nan Liu
  • “Through the back door: nurse migration to the UK from Malawi and Nepal, a policy critique” by Radha Adhikari and Astrida Grigulis

Budget Chief Is Obama’s Choice as New Health Secretary

(The New York Times) – On Friday, President Obama is to nominate Ms. Burwell, currently director of the White House Office of Management and Budget, to take over one of the largest and most unwieldy parts of the federal bureaucracy as secretary of health and human services. If confirmed, Ms. Burwell would replace Kathleen Sebelius, who is resigning.

Cost of Drugs Used by Medicare Doctors Can Vary Greatly by Region, Analysis Finds

(Washington Post) – An analysis of government data released Wednesday shows that the cost of drugs administered by doctors accounts for a growing piece of Medicare’s spending and varies widely from region to region in the United States, raising questions about whether some physicians may be misusing the pharmaceuticals. Most of the 4,000 doctors who received at least $1 million from Medicare in 2012 billed mainly for giving patients injections, infusions and other drug treatments, those records show.

Luring Medical Tourists for Cash Is a Trip Down the Slippery Slope

(The Globe and Mail) – So it looks like the ‘magic bullet’ solution has been found at last to cure Canada’s health care woes: medical tourism. Last week, Toronto’s Sunnybrook hospital defended its position to court affluent medical patients from other countries who can afford to pay generously for out-of-pocket care in a Canadian hospital. It’s a revenue-generating solution for a cash-strapped system, we are told. A handful of other hospitals already engage in this practice, and many across the country are starting to sit up and take notice. Should we break out the champagne and celebrate?

April 10, 2014

Access to Good Food as Preventative Medicine

(The Atlantic) – According to an article this month in the American Journal of Medicine, my patient’s predicament is common: nearly one in three U.S. adults with a chronic disease has problems paying for food, medicine, or both. Researchers at Harvard and the University of California at San Francisco studied data from the 2011 U.S. Centers for Disease Control’s National Health Interview Survey.

The Medicare Data’s Pitfalls

(New York Times) – The release on Wednesday of Medicare payment data is getting mixed reviews from doctors. Many say they favor sharing information but worry that the data presented by Medicare omits important details and may mislead the public and paint an unfairly negative picture of individual doctors.

Ensuring Privacy in the Study of Pathogen Genetics

(The Lancet, by subscription only) – Rapid growth in the genetic sequencing of pathogens in recent years has led to the creation of large sequence databases. This aggregated sequence data can be very useful for tracking and predicting epidemics of infectious diseases. However, the balance between the potential public health benefit and the risk to personal privacy for individuals whose genetic data (personal or pathogen) are included in such work has been difficult to delineate, because neither the true benefit nor the actual risk to participants has been adequately defined.

April 9, 2014

Fearing Punishment for Bad Genes

(New York Times) – About 700,000 Americans have had their DNA sequenced, in full or in part, and the number is rising rapidly as costs plummet — to $1,000 or less for a full genome, down from more than $1 million less than a decade ago. But many people are avoiding the tests because of a major omission in the 2008 federal law that bars employers and health insurers from seeking the results of genetic testing.

Data Uncover Nation’s Top Medicare Billers

(Washington Post) – The Medicare program is the source of a small fortune for many U.S. doctors, according to a trove of government records that reveal unprecedented details about physician billing practices nationwide. The government insurance program for older people paid nearly 4,000 physicians in excess of $1 million each in 2012, according to the new data. Those figures do not include what the doctors billed private insurance firms.

Event: Age, Ability, and Healthcare

Hiram College’s Center for Literature and Medicine and Northeast Ohio Medical University
Summer Seminar on Age, Ability, and Healthcare
Hiram College
Hiram, Ohio
July 17-18

See here for more information.

April 8, 2014

Drugstores Play Doctor: Physicals, Flu Diagnosis, and More

(The Wall Street Journal) – Currently there are about 1,600 walk-in medical clinics across the country in drug and big-box stores and supermarkets like CVS, Walgreens, Target and Kroger. The number is projected to double in the next three years due in part to the increased demands of newly insured patients under the Affordable Care Act, according to a 2013 report from Accenture, a global management-consulting firm.

Cognitive Impairment Common among Community and Nursing-Home Resident Elderly

(Medical Xpress) – More than 70% of elderly Medicare beneficiaries experience cognitive impairment or severe dementia near the end-of-life and may need surrogate decision makers for healthcare decisions. Advance care planning for older adults with dementia may be particularly important for individuals who do not reside in a nursing home or a long-term care facility, according to an article published in the April issue of Health Affairs.

April 7, 2014

‘Hackathons’ Aim to Solve Health Care’s Ills

(The Wall Street Journal) – Hackathons, the high-octane, all-night problem-solving sessions popularized by the software-coding community, are making their way into the more traditional world of health care. At Massachusetts Institute of Technology, a recent event called Hacking Medicine’s Grand Hackfest attracted more than 450 people to work for one weekend on possible solutions to problems involving diabetes, rare diseases, global health and information technology used at hospitals.

Even Small Medical Advances Can Mean Big Jumps in Bills

(New York Times) – Traditionally, insurers lost money by covering people with chronic illnesses, because they often ended up hospitalized with myriad complications as their diseases progressed. Today, the routine care costs of many chronic illnesses eclipse that of acute care because new treatments that keep patients well have become a multibillion-dollar business opportunity for device and drug makers and medical providers.

 

The Bioethics Poll
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