June 15th, 2011 by DrRich in Humor, Opinion
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Q. What is the difference between a public health expert and Il Duce?
A. Mussolini was not nearly as arrogant as a public health expert.
In prior posts, DrRich related how two major publc health efforts over the past few decades – the effort to put all of us on low-fat diets, and the effort to reduce everyone’s cholesterol levels – have amounted to massive experiments, based upon insufficiently-tested assumptions and surmises and hypotheses which the experts arrogantly (and incorrectly) determined to be fact, and which were conducted upon the entire American population without its knowledge or consent.
These public health experiments cost billions of dollars, needlessly transformed large swatches of American industry, and (at least in the case of low-fat diets) likely produced significant harm to the citizenry. Furthermore, despite such results, these misbegotten public health efforts have inured Americans to the notion that it is right and proper for government experts to determine for each of us what we must and must not eat.
DrRich now feels obligated to call his readers’ attention to yet another experiment which these same public health experts have launched, an experiment under which each of us – once again – is to become an unwitting research subject, an experiment whose results are unpredictable, but which has a realistic chance of producing harm to many of us. DrRich speaks, of course, of the new US dietary guidelines, published earlier this year, regarding sodium. Read more »
*This blog post was originally published at The Covert Rationing Blog*
May 20th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, News, Research
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It was 1999 when the Federal government first acknowledged our nation had a problem with race and health care. That year, Congress tasked the Institute of Medicine to study the matter, and the resulting report was not good. Minorities were in poor health and receiving inferior care, the report said. They were less likely to receive bypass surgery, kidney transplants and dialysis. If they had diabetes, they were more likely to undergo amputations, meaning their disease had been poorly controlled. And there was a lot more where that came from.
The IOM report was a call to action. In subsequent years, lawmakers crafted policies and established goals for improvement. Federal and state governments and numerous foundations set aside billions to fund projects. Health services researchers expanded their efforts to study the problem.
Twelve years later, we have something to show for the effort. Steep declines in the prevalence of cigarette smoking among African Americans have narrowed the gap in lung cancer death rates between them and whites, for example. Inner city kids have better food choices at school. The 3-decade rise in obesity rates, steepest among minorities, has leveled off.
Nevertheless, racial disparities persist across the widest possible range of health services and disease states in our country. The overall death rate from cancer is 24% higher for African-Americans than white people. The racial gap in colorectal cancer mortality has widened since the 1980s. African Americans with diabetes experienced declines in recommended foot, eye, and blood glucose testing between 2002-2007. Read more »
*This blog post was originally published at Pizaazz*
April 8th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Opinion
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One of the great challenges facing the folks who have been tasked to implement the Big O’s health care law is defining “essential benefits,” the core medical services that insurers must cover.
Despite its voluminous nature, the law is remarkably vague in this regard. It does identify 10 care categories that health plans must provide to consumers who use federally-funded health insurance exchanges to select a plan, but the categories and associated lists aren’t comprehensive or specific (the categories appear at the end of this post).
The Institute of Medicine has been tasked to flesh out the lists of required services. It has begun work amid a frenzy of lobbying by private insurers and consumer groups. Habilitative services are one contentious area, and they illustrate the challenges faced by the IOM. Unlike rehabilitative services which help people recover lost skills, habilitative services help them acquire new ones.
Habilitative services can help autistic children improve language skills, or those with cerebral palsy learn to walk. They can also help a person with schizophrenia improve his social skills. Read more »
*This blog post was originally published at Pizaazz*
March 9th, 2011 by LouiseHBatzPatientSafetyFoundation in Health Policy, True Stories
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This is a guest post by Dr. Julia Hallisy.
Serious infections are becoming more prevalent and more virulent both in our hospitals and in our communities. The numbers are staggering: 1.7 million people will suffer from a hospital-acquired infections each year and almost 100,000 will die as a result.
When our late daughter, Kate, was diagnosed with an aggressive eye cancer in 1989 at five months of age, our life became consumed by doctor visits, MRI scans, radiation treatments, chemotherapy — and fear. My husband and I assumed that our fight was against the ravages of cancer, but almost eight years later we faced another life-threatening challenge we never counted on — a hospital-acquired infection. In 1997, Kate was infected with methicillin-resistant staphylococcus aureus (MRSA) in the operating room during a “routine” 30-minute biopsy procedure to confirm the reoccurrence of her cancer.
Kate’s hospital-acquired infection led to seven weeks in the pediatric intensive care unit on life support, the amputation of her right leg, kidney damage, and the loss of 70 percent of her lung capacity. While most infections are not this serious, the ones that are often lead to permanent loss of function and lifelong disabilities. In the years since Kate’s infection, resistant strains of the bacteria have emerged and now pose even more of a threat since they can be impossible to treat with our existing arsenal of antibiotics.
Patients afflicted with MRSA will often have to contend with the threat of recurrent infections for the rest of their lives. These patients live in constant fear of re-infection and often struggle with feelings of vulnerability and helplessness. Family members, friends, and co-workers may not fully understand the facts and have nowhere to turn for education about risks and prevention. Loved ones may worry unnecessarily for their own safety, which can cause them to distance themselves from someone who desperately needs their presence and support.
We have the knowledge and the ability to prevent a great number of these frightening infections, but the busy and fragmented system in which healthcare is delivered doesn’t encourage adequate infection control measures, and patients continue to be at risk. A significant part of the problem is that the public doesn’t receive timely and accurate information about the detection and prevention of MRSA and other dangerous organisms, and they aren’t engaged as “safety partners” in the quest to eliminate infections. Read more »
February 2nd, 2011 by Mary Knudson in Health Tips, Opinion
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I confess to loving Campbell’s tomato bisque soup. I mix it with 1 percent-fat milk and it’s hot and delicious and comforting, but one of the worst food choices I could make because one cup contains more sodium than I should have in a day. Knowing this, I have already relegated it to an occasional treat. But by the end of this blog post I will do more.
We are overdosing on sodium and it is killing us. We need to cut the sodium we eat daily by more than half. The guidelines keep coming. The U.S. government has handed out dietary guidelines telling Americans who are over 50, all African Americans, people with high blood pressure, diabetes, or chronic kidney disease to have no more than 1,500 milligrams (mg) — or two thirds of a teaspoon — of sodium daily. That’s the majority of us — 69 percent. Five years ago the government said that this group would benefit from the lower sodium and now it made this its recommendation. The other 31 percent of the country can have up to 2,300 mg a day, say the guidelines from the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (HHS).
Or should they? The American Heart Association (AHA) recommends that all Americans lower sodium to less than 1,500 mg a day. Excessive sodium, mostly found in salt, is bad for us because it causes high blood pressure which often leads to heart disease, stroke, and kidney disease and can also cause gastric problems. People with heart failure are taught to restrict salt because water follows salt into the blood and causes swelling of the ankles, legs, and abdomen and lung congestion that makes it difficult to breathe.
I saw one recommendation by an individual on the Internet to just drink a lot of water to flush the sodium out of your body rather than worry about eating foods that have less sodium. BAD idea, especially for people with heart problems who need to restrict fluids to help prevent fluid accumulation in their bodies. The salt will draw the water to it.
But cutting our salt consumption by half is quite a tall order for an individual consumer because Americans have been conditioned from childhood to love salt and we on average consume 3,436 mg — nearly one and a half teaspoons — a day. Sodium is pervasive in our food supply. We get most of our sodium from processed foods and restaurant and takeout food, sometime in unexpected places. Read more »
*This blog post was originally published at HeartSense*
