July 22, 2019
Viewpoints: Nursing Homes And Hurricanes; Winning The War On Drugs A selection of opinions on health care from around the country. USA Today: Florida Health Care Association: We’re Dedicated The New England Journal Of Medicine: The Fate Of FDA Postapproval Studies The New York Times: How To Win A War On Drugs USA Today: In Hurricane Irma, Why Did Nursing Home Patients Have To Die? The New England Journal Of Medicine: Tuberculosis Elimination In The United States — The Need For Renewed Action Common usage notwithstanding, a flip-flop is actually a double inversion: First the flip — a reversal on an earlier position — then the flop — a return to the original position. A 360, to put it geometrically. A classic example is Barack Obama on same-sex marriage. In February 1996, when he was running for the state Senate, he expressed unequivocal support for gay marriage in candidate questionnaires, writing that he “would fight efforts to prohibit such marriages.” … A big question in Illinois these days is if Gov. Bruce Rauner will end up performing a “Full Obama” on the issue of Medicaid and state-employee health insurance funding of abortion services. (Eric Zorn, 9/21) The deaths have set off the predictable round of finger-pointing among the nursing home, the electric utility, state agencies and the governor over responsibility for decisions and ineptitude that turned deadly. This blame game avoids the real problem. The facility had one operable backup generator, which did not run air conditioning. And no one — not the federal government, not the state and not the county — required the facility to have an emergency generator dedicated to keeping fragile residents cool in a state that regularly experiences hurricanes, flooding and sweltering heat. (9/21) Both Congress and the Food and Drug Administration (FDA) have sought to accelerate the availability of new drugs by allowing sponsors to wait to resolve many questions about safety and benefit until after their drugs receive marketing approval. As a result, most approval letters require phase 4 studies to address issues such as optimal dosing, potential long-term side effects, and use in children or to confirm the clinical benefit of drugs that receive conditional approval on the basis of preliminary evidence. (Steven Woloshin, Lisa M. Schwartz, Brian White, and Thomas J. Moore, 9/21) Chicago Tribune: Cook County’s ‘Health’ Lie, In Black And White Bloomberg: Tom Price Flies Blind On Ethics The New England Journal Of Medicine: A Nicotine-Focused Framework For Public Health Decades ago, the United States and Portugal both struggled with illicit drugs and took decisive action — in diametrically opposite directions. The U.S. cracked down vigorously, spending billions of dollars incarcerating drug users. In contrast, Portugal undertook a monumental experiment: It decriminalized the use of all drugs in 2001, even heroin and cocaine, and unleashed a major public health campaign to tackle addiction. Ever since in Portugal, drug addiction has been treated more as a medical challenge than as a criminal justice issue. … Portugal may be winning the war on drugs — by ending it. Today, the Health Ministry estimates that only about 25,000 Portuguese use heroin, down from 100,000 when the policy began. (Nicholas Kristof, 9/22) This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Let Michael Bloomberg spend his millions to defend Cook County’s hated sweetened beverage tax. Opponents don’t need to pay a dime for advertising. That’s because taxpayers get a written reminder of this brazen cash grab every time they make a purchase. County Board members who are on the fence about next month’s vote to repeal the tax should keep that in mind. (9/21) Miami Herald: Protect Nursing Home Residents, Not Bad Facilities With the tools provided to the Food and Drug Administration (FDA) under the Family Smoking Prevention and Tobacco Control Act of 2009, the agency has taken consequential steps to prevent sales of tobacco products to children, expand the science base for understanding traditional and newer tobacco products, and conduct public education campaigns. But the agency needs to do more to protect Americans; in particular, we must shape a regulatory framework that reduces their use of combustible cigarettes. (Scott Gottlieb and Mitchell Zeller, 9/21) As caregivers dedicated to helping Florida’s frail elders, all of us at Florida Health Care Association grieve the loss of nine elderly residents of a single, non-member South Florida nursing home in the wake of Hurricane Irma. Our members accept the enormous daily responsibility of caring for Florida’s frailest residents. Ever since Florida’s horrendous storm season of 2004, we have committed to ongoing intensive disaster response training — most recently, the week before Hurricanes Harvey and Irma struck. (Emmett Reed, 9/21) When they get together in Tallahassee on Friday, the members of Florida’s nursing-home industry can either circle the wagons or lay the groundwork to take a deep, honest look at how best to confront the one the worst tragedies the industry seen. The Florida Health Care Association has called a “summit” to address emergency preparedness. This comes after eight, then nine and, as of Thursday, 10 elderly residents in a Hollywood Hills nursing home were left to suffer and die because they were in an stiflingly hot facility that lost electricity as Hurricane Irma blew through. (9/22) Under the lax ethical standards President Donald Trump brought to the White House, rampant conflicts of interest are treated with casual indifference. This disregard has sent a message to his entire administration that blurring lines — between public and private, right and wrong — will be not just tolerated but defended. At least one cabinet member appears to have taken the message to heart. (9/21) Once called “the captain of all these men of death,” tuberculosis continues to kill 1.8 million people globally each year. In 2014, the World Health Assembly embraced an ambitious resolution to reduce deaths from tuberculosis by 95% by 2035. But despite such global concern, tuberculosis has all but vanished from the U.S. public’s mind as a perceived threat. Although this lack of attention is understandable, given the substantial decrease in disease burden over the past several decades, it jeopardizes the prospect of tuberculosis elimination in the United States — a goal established by the Department of Health and Human Services in 1989. Critical ethical and policy questions must be addressed if elimination is to be pursued in earnest. (Ronald Bayer and Kenneth G. Castro, 9/21) Chicago Tribune: Will Rauner Complete A ‘Full Obama’ On Abortion Rights?