health care

If you have heart disease or diabetes and you are uninsured you are worse off than those who are insured by several measures. Those are the kinds of health conditions that usually worsen with age, too, so you would expect this to be a bigger problem for the uninsured near elderly. But they don't worsen for this group because when they hit 65 in the US they are no longer uninsured: they have the near universal health insurance coverage called Medicare, and as a result their health improves. Those are among the findings in a paper in the Journal of the American Medical Association (JAMA) by a…
We've discussed the scandal over the use of Avastin and Lucentis for wet macular degeneration several times (here, here, here). If you've missed it, here's the gist. Avastin is a drug approved to treat colon cancer. It works by choking off blood vessels to the tumor. It turns out, however, that a tiny dose of the same drug, when injected into the eye can also stop the uncontrolled growth of blood vessels behind the retina that produces a leading cause of blindness in the elderly, macular degeneration. The good news is a compounding pharmacy can take the large dose in the Avastin package and…
I'm happy to report that physician-journalist, Tom Linden, MD, has begun blogging over at Dr Mike Magee's Health Commentary. Dr Linden is currently Glaxo Wellcome Distinguished Professor of Medical Journalism and director of the Medical Journalism Program at the University of North Carolina at Chapel Hill J-school. As an example of the visibility of the program, one of Tom's current students, Kelly Rae Chi, just had an article posted at The Scientist on the history of the biotech industry in San Diego. Tom recognized early the power of the internet for health information and in 1995 co-…
Yes! "A Call for a Presidential Debate on Science & Technology." Imagine a presidential debate focused solely on issues of science and technology as they relate to medicine, international competitiveness, terrorism, public health, embryonic stem cell research, bioethics of genotyping and other molecular diagnostics, research policy/funding and job creation, or minimization of health disparities, among others.Science Debate 2008 is a grassroots initiative spearheaded by a growing number of scientists and other concerned citizens. The signatories to our "Call for a Presidential Debate on…
We've been speaking about this issue on behalf of our lymphoma colleagues since late August. But yesterday's New York Times (Alex Berenson) and Wall Street Journal's Health Blog (Jacob Goldstein) brought greater awareness to the issue of Medicare's proposal to cut reimbursement for "smart-bomb" radioimmunotherapies for lymphomas. So far, it appears that Medicare will move forward with plans to cut reimbursements for two RIT drugs, Bexxar® and Zevalin®, to less than their acquisition costs to hospitals. This issue had already mobilized Newsweek's Jonathan Alter to write a piercing screed…
I can't do any better than this today: I finally got around to reading yesterday's Cancer Research Blog Carnival that I cited and was completely entranced by Matthew Zachary's essay in The Huffington Post about his long battle with medulloblastoma. It was posted originally in July and provides outstanding insights on the life of a cancer survivor. While many oncologists are all too familiar with cases like Matthew's, this is required reading for anyone involved in cancer research, especially us basic scientists whose research is sometimes funded by organizations working toward "The Cure." Aw…
Some interesting research is being reported in the mainstream media: that buckwheat honey can reduce coughing and soothe sore throats as well as over-the-counter cough syrup (dextromethorphan), in children. ABC News specifically reported that, in comparison to baseline levels, coughing children who received honey slept better and coughed less that those that received cough syrup or nothing at all. I decided to go to the journal article, published in Archives of Pediatrics and Adolescent Medicine, and read about the results myself. The authors' objective was to compare honey, honey-flavored…
Gene therapy is the isolation of a gene, which is then packaged into a vector for introduction into the body in hopes that it can correct some aspect of genetic disease. Often this "vector" is a type of virus which had been specifically engineered to be safer than its original version. This usually involves removing the exons responsible for its transmission through all cell types, effectively "disabling" it. The virus will infect target cells and force them to produce the protein of interest, effectively replacing (or overexpressing) the protein in the body--which can be perpetuated. Gene…
Rabia Balkhi Hospital (RBH) is an obstetrical hospital in Afghanistan that is one of the jewels in the crown of the US aid effort after the overthrow of the Taliban in 2002. Here's the Department of Health and Human Services (HHS) website boast: HHS activities have had an enormous impact on the quality of care at RBH, have saved the lives of hundreds of women and newborns, and have improved significantly the skills and knowledge of the doctors, nurses and midwives at the hospital. We are continually adding new improvements that dramatically expand the hospital's life-saving capacity, such as…
No..it's a false alarm. [***or not - see note added at end of post] But I had to do a double-take last night when reading my e-mail notification of the new HealthCentral newsletter with the subject line: Celebrate Alzheimer's Awareness Month; How risky is your sexual behavior? For the grammar police out there, this is a great example of the difference in meaning of a semi-colon vs. a colon. However, given the size of the print on my screen and my pending need for bifocals, I couldn't tell the difference. Anyway, I blame the editors of the e-mail release for alarming me. Or maybe it was…
...is the title of a Newsweek article by Jonathan Alter posted online last night that draws more attention to the Medicare restriction on reimbursements for radioimmunotherapeutic (RIT) drugs used to treat lymphomas. Surgical oncologist, Orac, and I have spoken about this issue in the last few days. Alter admits his bias a bit, as he was diagnosed with mantle cell lymphoma back in 2004 and received RIT. Moreover, Alter's Newsweek colleague (and SoCal singer-songwriter), Jaime Reno, attributes RIT to his long-term remission. The article opens as follows: What if they found a cure for a…
The travesty has come true, according to Karl Schwartz and Betsy de Parry of Patients Against Lymphoma. The Centers for Medicare and Medicaid Services (CMS) has gone ahead with their plans to slash by half reimbursements to hospitals for two radioimmunotherapy drugs. For many hospital, reimbursement rates will be lower than their acquisition costs. We discussed this possibility back in August but had thought that CMS administrators would acknowledge the outcry from the lymphoma survivor/advocacy community, not to mention very strong statements from ASCO (American Society of Clinical…
Australia has a National Health System and, according to some of its doctors, it is crumbling. Aha, say the foes of American Universal Health Care, "I told you so." And I'll have to admit, they did. Fair is fair. So where is Australia's health system heading? Australia's public health system is crumbling, leading the country toward a US-style privatised health model, doctors say. Doctors Reform Society national president Con Costa wants federal Health Minister Tony Abbott to say whether he believes it is better to privatise the health system. (Sydney Morning Herald) John Howard, the George…
Bioterrorism defense dollars seem to be devoted mainly to procurement. This follows President Bush's prescription for how all Americans could defeat the terrorists after September 11: go shopping. Practicing what they preach, the federal government has gone on another buying spree for something we don't need: anthrax vaccine: The federal government has awarded a $400 million contract to Emergent BioSolutions for another 18.75 million doses of anthrax vaccine, with a bonus to be paid if the company wins approval for extending the vaccine's shelf life. The 3-year contract for BioThrax vaccine,…
Just a quick post about observations I had at a recent prostate cancer meeting conducted by the US Department of Defense's (DOD) Congressionally-Directed Medical Research Program (CDMRP). In the US, DOD is second only to NIH in the amount of funding provided for breast and prostate cancer research. The meeting was held in Atlanta and spread over three days - a nice small meeting with few overlapping sessions and great opportunities for interaction with speakers and fellow scientists. Most impressive, however, was the heavy presence of the cancer patient community in the proceedings. The…
A recent article in TimesOnline (hat tip RobT) raises an inevitable and interesting question about how we are going to ration scarce high tech medical resources in a pandemic. The article reports on a paper by Canadian scientists on SARS patients indicating that certain patterns of protein expression offer clues to clinical prognosis. In particular, the researchers found that protein expression patterns for interferons, known to participate in the innate immune system's reaction to viral infections, seem to indicate that one of two distinct patterns predict a relatively good prognosis, the…
By now you have probably heard of the excellent primer published in PLoS Medicine entitled, HIV Denial in the Internet Era. Written by my fellow ScienceBlogger, Tara Smith, and academic neurologist, Steven Novella, this concise but forceful article tells you everything you need to know about the faulty arguments made by organizations and individuals who deny that HIV is the cause of AIDS (HIV denialists, if you will). The article is free and it is simply awesome. Many bloggers have noted what to them is most important point of this article. For me, it is the first three sentences of the…
As promised, here is a second post on the situation in Australia, currently struggling through a very bad flu season. In the first post I quoted the late epidemiologist Irving Selikoff who referred to statistics as "people with the tears wiped away." Statistical summaries are the stock in trade of the public health profession but it is important to keep reminding ourselves of the ocean of tears we wipe away when we quote them. So it's back to Australia: He kissed her goodnight and she softly whispered: "I love you" so as not to wake their two young sons, fast asleep in her arms. It was the…
This is about the particularly severe flu season being endured by our friends in Australia. Southern hemisphere, so the flu season is in full swing there, the reverse of the northern hemisphere. But "full swing" doesn't quite describe it, so I'm going to do this one in two parts ((all links from Flu Wiki Front Page, news for August 18). The great epidemiologist Irving Selikoff once described statistics as people with the tears wiped away. So the first post today will be statistics, or the equivalent, without the tears . Later today I'll do the other part: As the flu epidemic continues to…
[Another post from two years ago. Everybody is talking universal health care now. Two years ago, nada. Well, almost nada. Below is what we said then (and continue to say, now). But first this, to show the original post is still current: Americans are living longer than ever, but not as long as people in 41 other countries. A major factor in the U.S. lagging in life expectancy is that 45 million Americans lack health insurance, experts say. For decades, the United States has been slipping in international rankings of life expectancy, as other countries improve health care, nutrition and…