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Magic mushrooms ease anxiety and depression in cancer patients in one dose

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Melissa Healy reports the good news in the LA Times:

In findings that could pry open a door closed for nearly half a century, researchers have found that psilocybin — a hallucinogen long used in traditional healing rituals — eases the depression and soothes the anxiety of patients contending with serious illness and the prospect of imminent death.

In two separate studies published Thursday, researchers report that trial subjects who received a single moderate-to-large dose of psilocybin got substantial and lasting relief from their profound distress. Among 80 cancer patients who participated in the two trials, as many as 4 in 5 continued to feel measurably less hopeless and demoralized six months after taking the drug than they had upon their recruitment.

And even years later, many reported they had gained — and retained — a profound sense of peace and meaning from the experience. Of 29 cancer patients who got psilocybin in a trial conducted at New York University’s Langone Medical Center, 20 rated it as “among the most meaningful” events of their life.

“This drug saved my life and changed my life,” said Dinah Bazer, a Brooklyn, N.Y., woman who was administered a single dose of psilocybin at a New York treatment center in 2011.

In the wake of treatment for ovarian cancer, Bazer said, her anxiety at the prospect of its return was “eating her alive.” Under the influence of a single high dose of psilocybin, Bazer said Wednesday, she became “volcanically angry” as she visualized her cancer as a dark mass bearing down on her. With an epithet, she then saw herself throwing it off.

“I was bathed in God’s love” for hours after that, said Bazer, who describes herself as an atheist. When the psilocybin’s hallucinatory effects wore off, she said, two years of intense anxiety were simply gone.

“This is a groundbreaking result,” said Dr. George Greer, medical director of the Heffter Research Institute, the nonprofit organization that funded the two trials.

Greer suggested that the “existential anxiety” of the terminally ill is only one of many conditions that psilocybin may one day treat. Others may include treatment-resistant depression, addiction to cocaine, alcohol or tobacco, obsessive-compulsive disorder and “demoralization” in long-term survivors of HIV, he said.

Johns Hopkins University psychiatrist Dr. Roland R. Griffiths, the lead author of one of the two studies, said the enduring relief provided by a single dose of psilocybin makes such treatment more akin to surgery than it does to the plodding, labor-intensive treatments that remain the mainstay of his profession.

“I really don’t think we have any models in psychiatry that look like” the effects demonstrated in the two trials, said Griffiths. “Something occurs and it’s repaired and it’s better going forward … very plausibly for more than six months,” he added. “In that sense it’s a new model.”

The publication of the two early trials, in the Journal of Psychopharmacology, marks an American return to research on the therapeutic use of hallucinogenic drugs after a hiatus of 50 years.

In the 1950s and ’60s, hallucinogenic drugs such as lysergic acid diethylamide — LSD — and psilocybin, which is found naturally in certain mushrooms, were widely used in U.S. biomedical research and in psychotherapy practices. But in 1966, as the psychedelic drugs gained a broad counterculture following in the United States, the U.S. government declared any use of the drugs illegal. By the 1970s, that ended all American research on their potential therapeutic benefits.

In recent years, a small clutch of American researchers, including the authors of the two new papers, have argued that such prohibitions might be preventing the discovery of better treatments for widespread and pressing psychiatric problems, including depression, addiction and post-traumatic stress disorder (PTSD).

With PTSD epidemic among U.S. combat veterans and drug addiction a national scourge, American officials have indicated a new willingness to allow research to proceed on psychedelic and other drugs long classified as having no legitimate medical use.

On Tuesday, the Food and Drug Administration gave its blessing to conducting large-scale clinical trials of an experimental medication  — 3,4-methylenedioxymethamphetamine — better known as the party drug ecstasy.

Like LSD and psilocybin, ecstasy appears to hold promise as an adjunct to psychotherapy in the treatment of PTSD. If the resulting Phase 3 trials of ecstasy demonstrate their effectiveness, the next step could be FDA approval of ecstasy as a prescription drug. . .

Continue reading.

The War on Drugs that Nixon initiated (against the advice of a presidential commission he formed) has done incalculable damage and blocked for decades the discovery of the benefits the drugs might bring. And I fear with Jeff Sessions as Attorney General we in for a big regression.

Later in the column:

In one of the trials, researchers used a very low dose of psilocybin, much lower than that required to induce hallucinations, as a placebo. In the other, they used the dietary supplement niacin. In each trial, all of the subjects got a high dose of psilocybin in one of two sessions. So all, in the end, experienced the full effects of the drug.

All subjects in both trials had been diagnosed with cancer, and with “existential anxiety or depression” resulting from the illness and the likelihood of an early death. Participants were extensively prepared for the expected effects of the psilocybin. To minimize adverse reactions, researchers closely monitored the subjects while they were under the influence of the drug or the placebo. Afterwards, psychotherapists encouraged the subjects to write down and reflect upon the experience.

Immediately after, as well as five weeks after their first session, subjects who got the psilocybin first looked much better than did those who got the placebo first. A wide range of standardized measures of depression, anxiety and quality of life showed that these subjects were less hopeless, less demoralized and less anxious.

Six months out, 87% of those in the trial conducted at New York University/Langone reported their life satisfaction and/or well-being had been improved by the experience. In the larger of the two trials, conducted at Johns Hopkins University, psilocybin produced “large and significant … increases in measures of quality of life, life meaning, death acceptance, and optimism” — effects that “were sustained at six months.”

Psilocybin’s side effects, meanwhile, were pretty tame. In the two trials, about 15% of subjects experienced nausea or vomiting when getting a high dose, and about 1 in 3 experienced some form of transient psychological discomfort. Many subjects’ heart rates and blood pressure rose, but none to a dangerous extent.

The potential use of psilocybin in patients diagnosed with life-threatening diseases comes at a moment when medical care at the end of life is a subject of growing concern among patients and physicians. Research finds it’s still common for dying patients to get painful and futile procedures. Palliative and hospice care, both aimed at easing the discomfort of the seriously ill, are growing specialties in American hospitals. An increasing number of patients, meanwhile, are demanding the right to die with a physician’s help.

As states debate these physician-assisted suicide bills, they should consider the implications of finding an effective treatment for the “existential distress” of the dying, said Dr. Craig D. Blinderman, a palliative care specialist at Columbia University Medical Center/New York Presbyterian Hospital.

And there’s a lot more. Worth reading.

Written by LeisureGuy

2 December 2016 at 10:47 am

The problems with Price’s Obamacare replacement

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Kevin Drum lays it out:

The Washington Post tells us this morning that we have another new member of the incoming cabinet:

Trump picks fierce Obamacare critic as health and human services secretary

His name is Tom Price, a Republican member of Congress from Georgia, and the fact that he’s a “fierce” critic of Obamacare doesn’t really faze me. He’s a Republican, after all. Anyone Trump picked would be a fierce critic of Obamacare.

However, there is something different about Price: he actually has a replacement plan. Not a white paper, but actual legislation. Sarah Kliff runs down Price’s plan here, but I want to pull back from the details and focus on the bigger picture instead.

You’ve probably heard a million times that Obamacare relies on a three-legged stool. If you want universal coverage, you have to require insurers to cover everyone, even those with pre-existing conditions. That’s guaranteed issue. But that will wreck the insurance pool: it will have too many sick people, who will rush to buy coverage, and not enough healthy people. So you also need to provide an incentive for healthy people to join your plan. In Obamacare, that’s the tax penalty for going without insurance. Finally, once you’ve done that, you have to provide financial help for the poor, since they can’t afford full-price coverage no matter how much incentive you give them. In Obamacare, that’s the subsidies.

This is not just an Obamacare thing. It’s true of all health insurance. Take the employer market that most of us are familiar with. Everyone who works for a company that offers health coverage gets it. That’s guaranteed issue. It’s pretty cheap and the price is deducted painlessly from your paycheck. That’s an incentive for everyone to join. And the company provides the insurance either free or at a very discounted price. That’s the equivalent of Obamacare’s subsidies.

So how does Price’s plan work? He mandates that insurance companies cover even those with pre-existing conditions. That’s guaranteed issue. However, insurers are only required to take you on if you maintain continuous coverage. That’s a huge incentive for healthy people to buy insurance, since if you skip it for a year you might not be able to get coverage if you get sick. Finally, he offers tax credits based on age to everyone, and a high-risk pool for those who still can’t afford insurance. That’s very similar to Obamacare’s subsidies.

So what’s the problem? Why shouldn’t Democrats ditch Obamacare and accept Price’s substitute? Or to flip things around, why should Republicans bother with this? If they’re just going to get a different version of Obamacare from Price, why not skip the whole thing? . . .

Continue reading.

Do read the rest of the column. It’s grim. We’re so screwed.

Written by LeisureGuy

29 November 2016 at 2:32 pm

How Idaho’s Drug Warriors Crushed Hope in Epileptic Kids

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Eric Boehm reports in Reason:

In December 2014, Josh Phillips’ mother answered the phone to news no parent wants to hear. Her son, an epileptic high school senior and champion wrestler, was in the hospital.

The whole Salmon High School wrestling team was waiting at Steele Memorial Medical Center when Jeanette and Gary Phillips got there. The team had been on its way home from a match at West Jefferson High, more than an hour away and out of cellphone range in the rugged backcountry of northeastern Idaho, when Josh Phillips suffered the worst seizure of his life.

As the bus raced back to Salmon, Josh went in and out of consciousness. He stopped breathing at least once.

“We thought we were going to lose him,” recalls Jason Bruce, the team’s coach.

Josh had been diagnosed with epilepsy when he was 10 years old, but he’d been wrestling since he was much younger, following in the footsteps of his father and older brother. Josh was the best of the bunch. He’d never been pinned during his four years at Salmon High, and Bruce says Josh was a clear favorite to win the state championship at the end of his senior season.

He never got the chance.

After a frantic drive through the mountains, Bruce was finally able to call an ambulance to meet the bus and Josh made it to the hospital where he was stabilized. But the incident on the bus forced the school’s hand, and the decision was made that Josh would no longer be allowed to travel with the team. It was too dangerous.

Now, instead of dreaming of a championship, Josh is just hoping for a normal life. He’s tried more than a dozen different medications and even underwent brain surgery. But the seizures that denied him a shot at a state title now prevent him from pursuing even the most mundane goals of the average 19-year-old. He can’t go to college and probably won’t be able to move out of his parents’ house. He’s not allowed to drive a car, and won’t get permission until he can show doctors that he’s having less than one seizure per month.

With pharmaceutical and surgical treatments unsuccessful, the Phillips family and others in Idaho placed their hopes in the legalization of cannabidiol oil, or CBD, a form of medical marijuana. Though not guaranteed to work for everyone, CBD has been shown to be effective in controlling seizures in some epileptic patients. For that reason, it’s been legalized in dozens of states as a medical treatment, including many states where more widespread uses of medical marijuana remain banned.

In Idaho, a bill to allow people like Josh Phillips to access CBD oil was passed by the state legislature in 2015, only to be defeated by a group of powerful special interests—including cops, prosecutors, and pharmaceutical companies—with direct access to policy makers in Boise. Emails obtained by Reason reveal a behind-the-scenes effort organized by the state’s Office of Drug Policy to derail the CBD legislation and, after it passed against the wishes of Gov. Butch Otter and his administration, to use executive authority to replace the bill with an alternative treatment program that has done nothing to help Josh Phillips or many other Idahoans suffering from seizures.

In the middle of it all was a governor who had for years professed support for ending drug prohibition, only to turn his back when the opportunity came.

Nearly 20 years before Josh Phillips was born, Clement Leroy “Butch” Otter was already pushing for marijuana to be legalized in Idaho.

In 1978, the future governor was a 35-year-old two-term state lawmaker who was running as something of a radical upstart in the state’s gubernatorial election.

“If a person, of his own free will, wants to use marijuana, I question whether the government has any propriety in telling him he can’t,” Otter told Reason that year. “The government, in effect, is taking away the only real gift the Lord gave us.”

Intentionally or not, Otter was suggesting that socially permissive policy choices were compatible with—and perhaps even logically following from—a worldview informed by Christian religious tradition. Free will demands that people be allowed to go their own way, take their own risks and make their own mistakes. That’s a perspective that fits with Idaho’s religious conservative culture—and one that runs directly against any notion of government-enforced prohibition.

Otter lost his first gubernatorial race in 1978, finishing third in a seven-way GOP primary. But he won his next race, for lieutenant governor in 1986. He would win re-election to that post three times before earning a seat in Congress in 2001.

As lieutenant governor and during three terms as the representative from Idaho’s First Congressional District, Otter developed a reputation for being a free thinker with a high degree of skepticism toward government power.

In 1987, Democratic Gov. Cecil Andrus left the state to attend a conference, leaving Otter to serve as acting governor. While in that role, Otter vetoed a bill that would have raised the legal drinking age in Idaho from 19 to 21 in order to allow the state to access federal highway funds. He said the bill was tantamount to giving into federal blackmail.

Starting in 1999, Otter fought a two-year personal battle with the Environmental Protection Agency (EPA) after being cited for building an illegal pond in his backyard. The EPA said he was disturbing a protected wetland, but Otter maintained that he was allowed to do as he pleased on his own property.

In Congress, he gained notoriety for being one of three Republicans—along with Ron Paul of Texas and Robert Ney of Ohio—to vote against the PATRIOT Act in 2001.

In 2006, after three decades in politics, Otter found himself back where he started: campaigning for governor and talking to Reason magazine about why Idaho should legalize marijuana, at least for medical purposes.

“I still support medical marijuana,” Otter said in 2006, just weeks before he was elected governor. “Some of these people, the only way they can get relief is by smoking marijuana.”

Nine years later, after winning a third consecutive term as the state’s chief executive, Otter finally had a chance to put his name on a law that would legalize, for the first time in the state’s history, a form of marijuana to treat medical issues like seizures. The bill was SB1146.

He vetoed it. . .

Continue reading.

Do click the link and read the rest. It’s a sorry story, but it’s part of the US today. Later in the article:

. . . Unlike Rice, Otter wasn’t convinced. Ten days after the CBD bill passed in the House, the governor issued his veto with a message scolding the legislature for passing the bill against the wishes of the state’s law enforcement special interests.

“I don’t know what more I or senior members of my administration could have done to help legislators understand our strong opposition to this legislation,” he wrote in his veto message. “Both the House and Senate were told by the Office of Drug Policy, the Department of Public Welfare, and the Idaho State Police—as well as prosecutors and local law enforcement officers throughout Idaho—that there were too many questions and problems and too few answers and solutions in this bill to let it become law.”

Forced to choose between the families and children who wanted CBD oil legalized and the opposition from law enforcement, Otter chose the latter—though he said he “sympathized with the heartbreaking dilemma” facing Idahoans dealing with debilitating diseases that could potentially be treated with CBD.

Jon Hanian, Otter’s spokesman, says the governor stands by the veto. Asked how that decision squares with decades of professed support for marijuana legalization, Hanian said Otter admits to changing his position. . .

No kidding. What’s the word for when you support something so long as it can’t happen, but when it can happen you oppose it? Opportunism? Hypocrisy? Dishonesty?

Do read the whole thing. It provides quite a bit to ponder. Later, for example:

. . . In his veto message, Otter explained his decision by warning of “the potential for misuse and abuse with criminal intent.” He cited the lack of support from Idaho’s law enforcement groups, and said that legalizing CBD oil could “decrease public safety,” without explaining how.

The law enforcement community’s own explanation for its opposition wasn’t any better.

“It basically opens the door, carte blanche, to make it almost unenforceable for us to be able to stop marijuana or illegal drugs in our communities,” said Shane Turman, president of the Idaho Chiefs of Police Association, at a hearing of the state Senate State Affairs Committee concerning the CBD oil bill in March 2015.

“The bill is the most liberal CBD bill in the country,” declared Bryan Taylor, president of the Idaho Prosecuting Attorneys Association, at the same hearing. “There are no regulations or safeguards.”

Rice, the Republican legislator who sponsored the CBD legislation, sees things differently. He says the state legislature worked with law enforcement to rewrite parts of the bill in an attempt to address those concerns. The final version of the bill would have required written permission from a doctor before a patient could obtain CBD oil and allowed doctors to prescribe CBD oil only for the treatment of intractable seizures after other medical options had been tried. There was nothing in the CBD bill that would have prevented police from arresting anyone for illegally obtaining or using marijuana or marijuana-derived products. . .

And this is Idaho, which presents itself as supporting the individual, etc. What a bunch of hypocrites.

Later we start to see the real reasons for Otter’s about face:

. . . If we take Otter at his word—and the word of his spokesman—then it was law enforcement’s opposition to the CBD oil bill that convinced the governor to veto it, and general concern about the public safety consequences of legalizing marijuana that convinced him to change his long-held views on the topic.

There may have also been a second factor pushing Otter’s administration to oppose the bill and favor a clinical trial of a particular drug instead.

The Pharmaceutical Research and Manufacturers Association, or PhRMA, represents drug companies and lobbies on their behalf. According to federal lobbying data aggregated by Maplight, PhRMA has spent more than $150 million on lobbying since 2008—a total that only includes federal advocacy efforts, not similar work done in state capitals.

But Big Pharma is active in the states too, and drug companies have been particularly keen on fighting efforts to legalize medical marijuana in all its various forms, including CBD oil.

That’s because states with legal medical marijuana have lower rates of drug prescriptions. In a study published earlier this year, Ashley and W. David Bradford, a daughter-father pair of researchers at the University of Georgia, analyzed state-level prescription drug databases from 2010 through 2013 and found that doctors prescribed significantly fewer pharmaceutical drugs in states with legal medical weed. The largest drop-off was for prescription painkillers, with 1,800 fewer doses prescribed annually in states with medical marijuana laws. They found a significant decline—486 fewer doses annually—in prescriptions for anti-seizure drugs as well.

In Idaho, PhRMA employs two full-time lobbyists to influence public policy. It also spends lots of money helping to elect state lawmakers from both sides of the aisle—including Otter. . .

Written by LeisureGuy

23 November 2016 at 5:26 pm

NFL doctors should not report to teams, Harvard study recommends

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The conflict of interest is obvious. If you don’t understand this, let me suggest this thought experiment. You are given a factory. You learn that the quality control inspectors are all paid by one of your competitors. Would you want to change that? (If so, you can understand why having the doctors, whose sworn mission is to protect the patient, paid by the NFL is a problem—fortunately, a problem easily solved.)

Rick Maese reports in the Washington Post:

A new report from Harvard University proposes drastic changes in the way health care is administered in the NFL, urging the nation’s most popular sports league to upend its system of medicine and untangle the loyalties of the doctors and trainers charged with treating players.

Asserting that the long-standing current structure has inherent conflicts of interest, the 493-page report outlines a new system in which a team’s medical staff is devoted solely to players’ interests and no longer reports to team management or coaches.

“The intersection of club doctors’ dual obligations creates significant legal and ethical quandaries that can threaten player health,” the report states.

The two-year study bills itself as the first of its kind in “examining the complicated and often-paradoxical universe of stakeholders that may influence NFL player health.” The NFL strongly took issue with the methodology and conclusions drawn by the Harvard researchers.

On Nov. 1, Jeffrey Miller, the NFL’s executive vice president of health and safety, sent the researchers a 33-page response in which he rejected any suggestion that NFL doctors have conflicts of interest and called the proposed change “untenable and impractical.” He said researchers have called for “several unrealistic recommendations that would not improve player care.”

The report “cites no evidence that a conflict of interest actually exists,” Miller wrote. “. . . The Report identified no incident in which team physicians were alleged to have ignored the health status of players, failed to adhere to patient confidentiality consent procedures, or made recommendations to clubs that were contrary to the health of players.”

The report — called “Protecting and Promoting the Health of NFL Players: Legal and Ethical Analysis and Recommendations” — is authored by members of Harvard Law School’s Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics. It is part of a multiyear, multimillion-dollar project that includes several Harvard studies examining the well-being of NFL players. Though funded by the NFL Players Association, the research is independent, and Harvard officials stress that neither the union nor the league has any control over the studies.

An NFLPA spokesman declined to comment on the study’s conclusions, and the union also declined an offer by researchers to submit a written response, similar to the NFL’s.

In interviews, the Harvard researchers say they were surprised by the league’s response.

“I had expected we’d maybe be quibbling around the margins of how it would actually be implemented,” said Holly Fernandez Lynch, the executive director of the Petrie-Flom Center and one of the report’s authors. “I did not expect that we would have to have this conversation about whether there is, in fact, a conflict because it’s so obvious on its face.”

“Admitting you have a problem is the first step to get over,” added Harvard law professor Glenn Cohen, another of the report’s authors, “and while we think many of the people who serve as club medical staff are wonderful doctors and excellent people — this is not to besmirch them or their reputation — it is not going to produce a good system if you’re operating under an inherent structural conflict of interest and one that is corrosive to player trust. . .

Continue reading.

You have to wonder why the NFL management wants to be able to hire, pay, and fire the doctors, but then you realize it’s obvious: They want to be able to stop the doctor from in any way hurting profits, and that might require that the doctor not follow the course that’s best for the patient. They apparently believe that if the players get proper medical care and sound medical opinions, it would hurt profits. Think about that for a while, and you can see why the NFL is a morally corrupt and unethical organization.

Written by LeisureGuy

18 November 2016 at 2:32 pm

Parents are insisting on doctors who insist on vaccinations

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Lena Sun reports in the Washington Post:

Pediatricians around the country, faced with persistent opposition to childhood vaccinations, are increasingly grappling with the difficult decision of whether to dismiss those families from their practices to protect their other patients.

Doctors say they are more willing to take this last-resort step because the anti-vaccine movement in recent years has contributed to a resurgence of preventable childhood diseases such as measles, mumps and whooping cough. Their practices also have been emboldened by families who say they will only choose physicians who require other families to vaccinate.

But the decision is ethically fraught. Doctors must balance their obligation to care for individual children against the potential harm to other patients. They must respect parents’ right to make their own medical decisions. And they need to consider the public health consequences of a refusal to treat, which could result in non-vaccinating families clustered in certain practices, raising the risk of disease outbreaks.

Until recently, the American Academy of Pediatrics considered it unacceptable to refuse families for not vaccinating.

At the large Salem, Ore., pediatric practice where Mark Helm is a partner, clinicians eventually felt that their top priority was to protect their many medically fragile patients, including children with cancer or weak immune systems and infants not yet old enough to be fully vaccinated. Last year, Childhood Health Associates of Salem became the first practice in Oregon to require all of its families to vaccinate their children fully and on schedule for the diseases most easily spread from person-to-person contact.

“Our policy happened because it simply did not seem ‘just’ to permit the kids who could not be vaccinated to face dire risks because another child’s parent ‘disbelieved’ vaccination,” Helm explained. “We did not want anyone to get measles because they passed through our waiting room.”

In response, about a dozen families out of several thousand chose to leave the practice, Helm said. But other doctors’ groups in the community followed Childhood Health’s lead and adopted similar measures. The overwhelming majority of Childhood Health’s families have supported the move, blurting out thanks in person, on the practice’s website and Facebook page.

“These are young parents and they’re saying, ‘I’m so glad about your policy. . . . I don’t understand why people don’t vaccinate their kids,’ ” Helm recalled. “That kind of spontaneous comment did not used to happen.”

After years of meeting hesi­ta­tion or reluctance from parents, he said, “it’s just nice to hear parents say that — that they want their children to be vaccinated.”

Some of the heightened appreciation of vaccines grew out of a 2015 measles outbreak that started at Disneyland in California. A single, unvaccinated child with measles led to the infection of 131 people, many of whom also were unvaccinated. One infected adult who visited several hospitals ended up exposing 98 infants, 14 pregnant women and 237 hospital employees, according to the California Department of Public Health.

Following the Disneyland outbreak, California passed a law that requires almost all schoolchildren to be fully vaccinated to go to school, allowing only some medical exemptions. The debate over the bill helped raise awareness of the dangers of measles and other preventable diseases.

For years, the official position of the AAP was not to dismiss vaccine-resistant families. But recently, the AAP recognized what many individual pediatricians have been wrestling with on an ad hoc basis. This summer, it announced for the first time that dismissal is now an acceptable option if doctors have exhausted counseling efforts. . .

Continue reading.

Written by LeisureGuy

13 November 2016 at 8:06 am

Despite being shamed for overcharging patients, hospitals raised their prices, again

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Single-payer healthcare and non-profit hospitals look better and better. Lena Sun reports in the Washington Post:

A year ago, a study about U.S. hospitals marking up prices by 1,000 percent generated headlines and outrage around the country.

Twenty of those priciest hospitals are in Florida, and researchers at the University of Miami wanted to find out whether the negative publicity put pressure on the community hospitals to lower their charges. Hospitals are allowed to change their prices at any time, but many are growing more sensitive about their reputations.

What the researchers found, however, was that naming and shaming did not work. The researchers looked at the 20 hospitals’ total charges in the quarter of a year before the publicity and compared them to charges in the same quarter following the publicity. There was no evidence that the negative publicity resulted in any reduction in charges. Instead, the authors found that overall charges were significantly higher after the publicity than in previous quarters.

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“We were thinking we would see a drop or lowering of some charges,” said Karoline Mortensen, one of the authors of the study published in the Journal of Health Care Finance earlier this year. “There’s nothing stopping them,” she said, referring to the hospitals. “They’re not being held accountable to anyone.”

Researchers say the main factors leading to overcharging are the lack of market competition, lack of hospital transparency and the fact that the federal government does not regulate prices that health-care providers can charge. Only two states, Maryland and West Virginia, set hospital rates.

When the original study was published, shares of Community Health Systems, which owns many of the 50 hospitals listed with the highest markups, traded with almost triple the volume of the preceding weekday, suggesting shareholders had concerns about the system’s pricing practices, the University of Miami researchers said. Share price fell by $1.39 that week, or more than 2.5 percent, but recovered by the end of that week.

Understanding hospital pricing and charges is one of the most frustrating experiences for consumers and health-care professionals. It is virtually impossible to find out ahead of time from the hospital how much a procedure or stay is going to cost. Once the bill arrives, many consumers have difficulty deciphering it.

After a Utah man posted a photo of his hospital bill on Reddit, showing a$39.35 charge for what he thought was for holding his newborn, his post triggered more than 11,000 comments. . .

Continue reading.

Written by LeisureGuy

20 October 2016 at 6:29 pm

Inside NFL’s Backwards Marijuana Policy

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Ross Benes reports in Rolling Stone:

At the conclusion of North Dallas Forty wide receiver Phil Elliott, played by Nick Nolte, gets blackballed by his team owner for “smoking a marijuana cigarette.” After being presented with a photo that shows Elliott toking up, the team owner patronizes Elliott and says, “Illegal drugs are forbidden by the league rules Phil, you know that.” To which Elliott replies: “Jesus, smoking grass, what are you kidding me? If you nailed all the ballplayers who smoked grass, you wouldn’t even be able to field a punt return team. Besides that, you give me the hardest stuff in Chicago just to get out of the goddamn locker room. Hard drugs!”

Though North Dallas Forty is technically fictional and came out nearly 40 years ago, its story is a classic example of the same-shit-different-day phenomenon. In recent weeks, Bills linemen Marcell Dareus andSeantrel Henderson were each suspended four games for using marijuana. And Cowboys running back Ezekiel Elliott caused a scandalby simply walking into a legal weed-friendly establishment. Meanwhile, the NFL was busy knuckling players into “cooperating” with a doping investigation based on scant and recanted evidence.

Given America’s growing acceptance of cannabis, the bad press the NFL gets when it punishes marijuana use more harshly than domestic abuse, and the personal tragedies and lawsuits that have stemmed from team doctors overprescribing opioids, it seems a little peculiar that the NFL continues to retain an authoritarian stance on marijuana use while team doctors simultaneously dole out powerful and addictive painkillers. Especially considering that the league is mired in concussion suits and there’s a possibility that cannabis could reduce the impact of head trauma.

To get a better grasp of this dissonance, let’s take a look at the changing national perception of marijuana, possible incentives the NFL has for maintaining its marijuana policies, upcoming football-related cannabis research initiatives, and what it might take to get the NFL to stop punishing players for using marijuana.

Changing Context
As Kevin Seifert of ESPN pointed out, during the hysteria of the War on Drugs in the 1980s it was “politically and socially necessary” for the NFL to discipline marijuana users. But after the war on drugs proved to be a massive failure, people began viewing certain drugs more tolerantly, and now polls show that a majority of Americans support legalizing marijuana. As public support increased so did legalization, and today more than 60 percent (20 of the 32 teams) of NFL teams play in states that allow medical marijuana. Come November that percentage could grow as there are a plethora of state ballot initiativespushing for medical and recreational marijuana legalization.

There are also bills in the Senate and House aimed specifically at cannabinoids such as cannabidiol (CBD), which is a compound found in cannabis that doesn’t get people high. CBD is typically taken orally and it includes only trace amounts of THC, the psychoactive component of cannabis. A group of vocal ex-players are pushing the league to allow players to use CBD as a pain reliever. Because as the league’s policy currently stands, a player taking CBD could potentially surpass the league’s testing threshold and test positive.

“The risk [of testing positive for using CBD] is very low compared to the people using high-THC cannabis,” said Joel Stanley, CEO of hemp extracts producer CW Hemp. “But there certainly is a risk. But when you have something that you know is non-toxic, non-psychoactive, and non-addictive, and if you are in those high-impact situations, why not [allow players to] take that product?”

The NFL declined interview requests for this story. But a league spokesperson sent over the following statement:

Independent medical advisors to the league and the National Football League Players Association are constantly reviewing and relying on the most current research and scientific data. The league will continue to follow the advice of leading experts on treatment, pain management and other symptoms associated with concussions and other injuries.

It went on to say: . . .

Continue reading.

Written by LeisureGuy

22 September 2016 at 3:28 pm

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