Policy

In the 18 days between House Republicans’ introduction of the American Health Care Act and its withdrawal, women’s health was in the spotlight. With House Speaker Paul Ryan now stating that he’s going to try again on legislation to “replace” the Affordable Care Act, it’s worth looking at some of the ways the ACA has benefited women – and how actions from Congress and the Trump administration could affect women’s insurance coverage and access to care. Women gained coverage under the ACA The ACA’s biggest achievement was reducing the percentage of the population without health insurance. It did…
Many of us breathed sighs of relief on Friday when House Speaker Paul Ryan announced the withdrawal of legislation to roll back the Affordable Care Act. The bill, the American Health Care Act, would have resulted in 24 million people losing insurance and $880 billion less for Medicaid over the next 10 years -- while giving an $883 billion tax cut targeted to the wealthiest. At town hall meetings and over the phones, members of Congress heard from constituents urging them to leave the ACA’s coverage expansions in place. Yet the bill’s defeat doesn’t mean that the idea of healthcare coverage…
Yesterday, House Republicans failed to find enough votes to pass their Affordable Care Act replacement. It was a very good day for the millions of Americans projected to lose their coverage under the GOP plan. But let’s be clear: Obamacare is not safe. In a last-ditch effort to round up more votes, House Speaker Paul Ryan, R-Wis., proposed an amendment that would have, beginning in 2018, allowed states to determine the kinds of essential health benefits required in insurance plans purchased with tax credits. Under Obama’s health care law, insurance plans sold via the federal health care…
When it comes to the measles, antivaxers love to repeat a series of talking points. One is that measles is not a dangerous disease and was considered a normal part of childhood 50 or 60 years ago. This is what I like to refer to as the "Brady Bunch" gambit, mainly because antivaxers who try to make this argument often invoke an episode of The Brady Bunch from 1969, Is There a Doctor in the House?, in which all six kids contract the measles within a day of each other. Their illness is played for laughs, with the kids shown playing board games and enjoying having a few days off from school,…
A few of the recent pieces I recommend reading: Sarah Kliff & Ezra Klein at Vox: The Lessons of Obamacare Chris Ladd in Forbes: Unspeakable Realities Block Universal Health Coverage in the US Donelle Eller in the Des Moines Register: Iowa pollution enforcement could lose big under Trump EPA cuts, critics warn Teddy Wilson at Rewire: Texas Legislators "Ignore" Spiking Black Maternal Mortality Rates Linda-Gail Bekker & Anthony S. Fauci at STAT: Women are Leading the Way in HIV Research And because the House Republicans' healthcare bill is so consequential for public health and there's…
House Republicans have released –and rushed through two committees—the American Health Care Act, which would result in destabilized individual insurance markets and millions of people losing health insurance. The Congressional Budget Office hasn’t yet released its estimate of the likely impacts, but an analysis from authors at the Brookings/USC Schaeffer Initiative calculates it would result in 15 million people losing coverage. The AHCA contains provisions addressing both private and public insurance; I’m most concerned about the impacts on Medicaid, which would shift substantial healthcare…
Four years ago we were foster parents to two wonderful children whose family was broken up by deportation. The parents had overstayed their visas (ie, they entered the US legally), in part because their children were both born (while in the US, ie the children were citizens) with kidney disease and their homes in rural Central America had no hospitals to treat them nor adequate medical care. They left their country because they were part of a disenfranchised indigenous minority that was historically denied access to things like education - they could do better in the US. They also were a…
by Garrett Brown On February 10th, California’s Department of Industrial Relations (DIR) proposed revised and stronger regulations for oil refineries in the state after a 4½-year joint campaign by labor unions, environmental and community organizations to protect both refinery workers and nearby communities. The regulatory proposal now goes to the state’s Occupational Safety and Health Standards Board for consideration and final approval. This successful “blue-green” coalition held off industry pressure and reversed earlier back-door revisions to the proposal by DIR to benefit the oil…
The impetus for the creation of this blog, lo these 12+ years ago, was growing alarm at the rising tide of pseudoscience then, such as quackery, antivaccine misinformation, creationism, Holocaust denial, and many other forms of attacks on science, history, and reality itself. I had cut my teeth on deconstructing such antiscience and pseudoscience on Usenet, that vast, unfiltered, poorly organized mass of discussion forums that had been big in the 1990s but were dying by 12 years ago, having turned into a mass of spam, trolls, and incoherence. So I wanted to do my little part (and I'm under no…
Government scientists play essential roles in our country's top public health achievements. From food-safety improvements to tobacco cessation, we rely on them to warn us of health risks, identify solutions, and create standards that promote public health. The Trump administration puts our health at risk when it instructs science-based agencies to halt communications; requires political-appointee review of EPA science; gives attention to people who make dangerous and uniformed statements about vaccines; and selects an EPA administrator who ignores decades of evidence on climate change.…
Back in December, I took note of the vaccine situation in Texas. First, I pointed out how a new article by Peter Hotez, MD, a pediatrician at Baylor University, had sounded the alarm that the number of schoolchildren with nonmedical exemptions to the Texas school vaccine mandate had skyrocketed by 19-fold over the last 13 or 14 years. As if that weren't alarming enough, I discussed the resident antivaccine groups in Texas, who had become quite active. I thought that that was probably all I would write about Texas for a while. Silly me. Texas is fast turning into a series of its own, much as I…
Today's lesson is from Is Decoupling GDP Growth from Environmental Impact Possible? (h/t mt), by James D. Ward , Paul C. Sutton, Adrian D. Werner, Robert Costanza, Steve H. Mohr, Craig T. Simmons; October 14, 2016 http://dx.doi.org/10.1371/journal.pone.0164733. And here is their abstract. The argument that human society can decouple economic growth—defined as growth in Gross Domestic Product (GDP)—from growth in environmental impacts is appealing. If such decoupling is possible, it means that GDP growth is a sustainable societal goal. Here we show that the decoupling concept can be…
At Reveal, Jennifer Gollan reports on how the Navy and other federal agencies give lucrative contracts to shipbuilders with troublesome worker safety records. In fact, Gollan reports that since 2008, the Navy and Coast Guard’s seven major shipbuilders have received more than $100 billion in public funds despite serious — and sometimes fatal — safety gaps. She noted that in his first days in office, President Trump announced plans for a massive Navy fleet expansion, which could mean even more workers will be at risk. Gollan writes: With extra business comes more risks for workers. But there is…
A few recent pieces I recommend: Sarah Frostenson at Vox: Public health shouldn’t be contentious. But it’s incredibly polarizing. Mallory Falk and Eve Troeh at WWNO: Kids, Trauma and New Orleans Schools Vann R. Newkirk II in The Atlantic: Obamacare’s Unlikely Defenders Andrés Miguel Rondón in the Washington Post: In Venezuela, we couldn’t stop Chávez. Don’t make the same mistakes we did. Lizzie Presser in The California Sunday Magazine: Below Deck: Filipinos make up nearly a third of all cruise ship workers. It’s a good job. Until it isn’t.
Most of my regular readers probably haven't been following this blog long enough to know it, but early in its history this blog was more of a general skeptical blog. True, it always had a heavy emphasis on medical science and pseudoscience, but I also used to write about evolution and other topics from a skeptic perspective. Back then, dating back to the very earliest days after I discovered blogging, Holocaust denial was a frequent topic on this blog because it was a big interest of mine. It still is, even though I haven't had much opportunity to write about it over the last few years. It…
In a (very) few short hours, Donald Trump will take the oath of office and become the 45th President of the United States. I realize that I don't normally blog about politics, at least other than that related to medicine, but I make no bones about it. I'm dreading 12 Noon ET on January 20, 2017. There is more than enough reason for dread given the likely effect on medical science, at the very least. Also, Donald Trump is antivaccine. He's shown it through meetings with Andrew Wakefield and Robert F. Kennedy, Jr, the former of whom spoke a year ago on a "Conspira-Sea Cruise" and the latter of…
This is a descriptive model of Donald Trump's behavior, which ultimately works out to a prediction that Donald Trump won't last very long. In an evolutionary sense, at least. I've found that many people use the term "spite" incorrectly. Many assume it has to do with vitriol or nastiness, or otherwise, is motivated negative behavior of some kind. This is not even close to the scientific definition of the term. A daffodil plant can carry out an act of spite, and a daffodil plant is unlikely to engage in motivated behavior. Spite involves carrying out an act where the ultimate cost to…
One of the most important, if not the most important, officials in the federal government responsible for applying science-based medicine to the regulation of medicine is the FDA Commissioner. As you might imagine, particularly after his having met with antivaccinationists like Andrew Wakefield and Robert F. Kennedy, Jr., I am concerned, and I think I have good reason to be, about Donald Trump's plans for the FDA. After all, consider the people who have been under consideration for the post thus far (that we know of). First, there was Jim O'Neill, a flunky of Silicon Valley venture capitalist…
This will almost certainly be my last post of 2016. Unless something so amazing, terrible, or just plain interesting to me happens between now and tomorrow night, I probably won't be posting again until January 2 or 3. Many bloggers like to do "end of year roundup"-type posts that list their best or most popular post, trends noted in 2016 relevant to their area of blogging interest, or predictions for the coming year as their last post of the year, but that's never really been my style. I don't remember the last time I did a post like that, and I'm too lazy today to bother to go and look it…
There are times when I wonder: How on earth did I miss this? Usually, I pride myself on being pretty timely in my blogging, writing about new stuff that’s fairly fresh. Sure, barring a fortuitous confluence of events and timing, I’m rarely the “firstest with the mostest” on a topic. I do, after all, have a demanding day job and generally don’t mix blogging with my work if I can avoid it (although cranks seem to want to make that impossible with their latest tactic of infiltrating my cancer center’s Facebook page to post rants about how evil I am). There’s no way I can compete with bloggers…