Tags: healthcare*

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  1. The goal is to modify and adapt one of the Magic Candy Factory’s existing 3D printers so it can produce personalized medicines, mainly geared toward children, but with the ability to print precise doses, a combination of multiple drugs, and different formulations, like capsules and chewables.

    “A major limitation of medicines today is that they are only manufactured in a limited number of strengths,” the campaign page reads. “But, what if we need a dose that is not available on the market? This is of special importance to children and the elderly. The tablets and capsules we take every day are not designed with children in mind, often making administration difficult.”

    Incorrect doses, terrible taste, and being difficult to swallow are only a few of the issues doctors, and parents, face when trying to give children safe and effective medicine. The campaign quotes UNICEF when it says that 10 million kids under the age of five will die this year, and that 67% of that massive number could be saved by specific pediatric products, like better medicine.
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  2. A snap decision by Google has begun to reshape the drug treatment industry, tilting the playing field toward large conglomerates — the precise opposite outcome Google had hoped to achieve.

    The fateful decision was made September 14. Google faced pressure from an exposé in The Verge released a week earlier, documenting how shady lead generators game its AdWords system. High-cost ads based on rehab keywords referred users to phone hotlines that gave the impression of being independent information services, but were actually owned by treatment center conglomerates. Representatives, who reap large fees based on how many patients they sign up, employ high-pressure sales tactics to push people into their favored facilities, whether or not that facility is the right one for the patient.

    This deceptive marketing can lead to substandard treatment and massive overbilling. It also made lots of money for Google, which was shown in the story actively courting addiction treatment advertisers.

    And so Google made a quick call: It effectively stopped running ads from treatment facilities. At first blush, that may look like a happy alignment of the public good and a company’s need for good public relations, with Google taking a hit to make the world a better place in the midst of an epidemic.

    But the problem of economic concentration is so deep in the United States today that peeling back one layer merely reveals another. Without ads, addicts or their parents are left only with the organic search results.
    Tags: , , , by M. Fioretti (2017-10-30)
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  3. Britain’s obesity epidemic is fuelling devastating numbers of amputations - almost all of which could have been prevented, experts have warned.

    Official figures show the number of cases have reached an all-time-high, with more than 8,500 procedures carried out last year as a result of diabetes.

    Nine in ten cases of the condition are type 2, which is linked to obesity and inactivity.
    Tags: , , , , , by M. Fioretti (2017-09-29)
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  4. The Food and Drug Administration "strongly encourages" hospitals to stop using Hospira's Symbiq Infusion System, because it's vulnerable to cyberattacks that would allow a third party to remotely control dosages delivered via the computerized pumps. Unauthorized users are able to access the Symbiq system through connected hospital networks, according to the FDA and the Department of Homeland Security's Industrial Control Systems Cyber Emergency Response Team. ICS-CERT reported the vulnerability on July 21st and the FDA released its own safety alert on Friday, July 31st. Thankfully, there are no reported incidences of the Symbiq system being hacked.
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  5. you need not be wealthy to participate. All you need to gain access to socialism for white people is a good corporate or government job. That fact helps explain how this welfare system took shape sixty years ago, why it was originally (and still overwhelmingly) white, and why white Rust Belt voters showed far more enthusiasm for Donald Trump than for Bernie Sanders. White voters are not interested in democratic socialism. They want to restore their access to a more generous and dignified program of white socialism.

    In the years after World War II, the western democracies that had not already done so adopted universal social safety net programs. These included health care, retirement and other benefits. President Truman introduced his plan for universal health coverage in 1945. It would have worked much like Social Security, imposing a tax to fund a universal insurance pool. His plan went nowhere.

    Instead, nine years later Congress laid the foundations of the social welfare system we enjoy today. They rejected Truman’s idea of universal private coverage in favor of a program controlled by employers while publicly funded through tax breaks. This plan gave corporations new leverage in negotiating with unions, handing the companies a publicly-financed benefit they could distribute at their discretion.

    No one stated their intention to create a social welfare program for white people, specifically white men, but they didn’t need to. By handing control to employers at a time when virtually every good paying job was reserved for white men the program silently accomplished that goal.

    White socialism played a vital political role, as blue collar factory workers and executives all pooled their resources for mutual support and protection, binding them together culturally and politically. Higher income workers certainly benefited more, but almost all the benefits of this system from health care to pensions originally accrued to white families through their male breadwinners. Blue collar or white collar, their fates were largely united by their racial identity and employment status.

    Until the decades after the Civil Rights Acts, very few women or minorities gained direct access to this system. Unsurprisingly, this was the era in which white attitudes about the social safety net and the Democratic Party began to pivot. Thanks to this silent racial legacy, socialism for white people retains its disproportionately white character, though that has weakened. Racial boundaries are now less explicit and more permeable, but still today white families are twice as likely as African-Americans to have access to private health insurance. Two thirds of white children are covered by private health insurance, while barely over one third of black children enjoy this benefit.

    White socialism has had a stark impact on the rest of the social safety net, creating a two-tiered system. Visit a county hospital to witness an example. American socialism for “everyone else” is marked by crowded conditions, neglected facilities, professionalism compromised by political patronage, and long waits for care. Fall outside the comfortable bubble of white socialism, and one faces a world of frightening indifference.

    When Democrats respond to job losses with an offer to expand the public safety net, blue collar voters cringe and rebel. They are not remotely interested in sharing the public social safety net experienced by minority groups and the poorest white families. Meanwhile well-employed and affluent voters, ensconced in their system of white socialism, leverage all the power at their disposal to block any dilution of their expensive public welfare benefits. Something has to break.
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  6. Take the GOP effort to discredit the Congressional Budget Office’s analysis rather than working with the agency to build a better bill. For that play to work, they need credible, independent validators of their ideas. In 2009, when Democrats wanted to argue that the CBO was underestimating the savings from delivery-system reforms, they pointed to work by Harvard’s David Cutler, among others. The key to their argument was that top health experts disagreed with the CBO, and they made lengthy, plausible arguments explaining why. That’s what this looks like when you’re really trying.

    The House GOP isn’t really trying. The conservative intellectual apparatus is overwhelmingly against Ryancare — when you’ve lost Cato and Heritage and AEI and Yuval Levin and Avik Roy and Philip Klein, then discrediting CBO doesn’t come off as CBO is wrong, and here’s a persuasive argument for why; it comes off as we’re wrong, and we’re trying to make sure as few people as possible know it. It’s a flashing signal of weakness.
    Tags: , , by M. Fioretti (2017-03-12)
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  7. Two years ago I wrote about my experience in a London emergency department with my son, Victor. That post has since been viewed more than 450,000 times. There are over 800 comments with no trolls (a feat unto itself) and almost all of them express love for the NHS. I was in England again this week. And yes, I was back in an emergency department, but this time with my English cousin.

    My cousin loves high heels. As a former model she makes walking in the highest of heels look easy. However, cobblestone streets have challenges not found on catwalks and so she twisted her ankle very badly. Despite ice and elevation there was significant swelling and bruising and she couldn’t put any weight on her foot. I suggested we call her doctor and explain the situation. I was worried about a fracture. I hoped to arrange an x-ray. If it was broken we would arrange the needed care and if it wasn’t broken I could bandage it just as well at home.

    “No,” she said. She’d have to ring for an appointment. It was Friday around 11 am. The chance of getting into her GP by the end of the day was apparently non-existent. She would have to wait until Monday. Even if she were lucky enough to be seen that day there was no x-ray in his office so it would be a trip to see him and then a trip to the hospital. She was shocked when I suggested she call and just ask if he could order the x-ray. Apparently, that’s not how it’s done.

    As a gynaecologist I will admit feet are not my strong suit, but no medical degree was needed to confirm that she needed an x-ray. She also has some health issues that could impact healing from a break or the timing of surgery (hopefully that wouldn’t be needed, but you never know), so a timely diagnosis was important for her.

    “We’re going to the emergency department I said,” and off we went to Sunderland Hospital.

    Getting to the actual emergency room (ER) from the parking area required a background in orienteering. There was loads of construction and we had to go down hallway, after hallway, with Hogwarts’ worthy twists and turns. I managed to find a wheelchair, an unwieldy apparatus that only works in reverse - on purpose. This is to stop wheelchair theft, which is apparently a serious problem at Sunderland Hospital.

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    Owen Smith on the NHS

    My cousin was triaged immediately. Within two minutes a nurse checked her ankle, gave her codeine, and then sent her off to an urgent care clinic. She wasn’t even registered in the ER. A porter wheeled her to the urgent care clinic in another building some distance away, which required a trip outside.

    “What if it rains?” I asked the porter.

    “We get wet. This is the North,” he said. “Of course it rains. Almost every day.”

    Apparently no one complains.

    The urgent care clinic had a few people ahead of us. It took about 10 minutes to check in and then no more than 15 minutes to be seen. A lovely nurse named Leslie triaged my cousin and agreed an x-ray was in order and made the arrangements. My cousin did not need to see a doctor or a nurse practitioner to get an x-ray. I’m not sure I’ve ever seen that happen in the US.

    The x-ray and radiology report took 10 minutes. Then a nurse practitioner (also very nice) did an appropriate history and exam. The diagnosis was a torn ligament (sprain) and possibly a small fracture of the lateral malleolus (outside ankle bone). An orthopaedics consultation was needed. She could either wait and be squeezed into fracture clinic that afternoon, or she could have a cast and come back to Saturday fracture clinic. The clinic didn’t start until 2pm and we were done in urgent care by 1pm, so she opted to wait. She was seen around 2.15pm. An orthopaedic consultant did an exam and recommended a tight support bandage and gave her exercises and guidelines about how to follow-up if she wasn’t meeting milestones.

    My cousin was at the hospital for four hours, one hour of this was an unavoidable wait for the fracture clinic and about 30 minutes of transport back and forth between the ER, urgent care, and fracture clinic.
    UK news in pictures

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    To receive this care all my cousin had to do was provide her name and birthdate. No co-payments, no pre-authorisations, no concerns about the radiologist or orthopaedic surgeon being out of network. The nursing triage was wonderful and actually doing nursing (I hate seeing nurses relegated to charting). The nurse practitioner clearly knew what she was talking about and had reviewed the films with the radiologist.
    Tags: , , , , by M. Fioretti (2017-01-09)
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  8. Milton Friedman, the influential ‘free market’ ideologue and economist, supported a guaranteed income as a way for the state to fulfil social obligations without interfering with the market, arguing that it ‘should replace the ragbag of specific welfare programs’.1

    Business website FastCoExist suggests, ‘A basic income could replace multiple types of public assistance – from healthcare to earned tax credits – with a single payment.’2 One of the largest trials of a basic income to date is the $22.4-million experiment planned by the rightwing Finnish government – who are also cutting health, education and welfare.3

    Increased talk of a basic income comes at a time of the voucherization, marketization and decimation of public services. Sweden, Chile and New Orleans have introduced schemes where parents are given vouchers to pay for either state or private schooling.4 In England, ‘personal health budgets’ and large-scale outsourcing are being forced on the health service, while Spain has introduced ‘co-charges’ for healthcare.5

    The policy could give the Right the justification it wants to eviscerate the social state further, and would make it harder to argue for an expansion of public services. The payment could easily be eaten up by the cost of paying for previously public services, and as, depending on the implementation, the basic income does not necessarily redistribute more money to the poorest, a rightwing programme that introduced a basic income amid cuts could leave many worse off. In Britain, the cost of a degree – previously fully funded – would take several decades of basic income to repay at the level proposed in 2013 by the Citizen’s Income Trust.6

    Many services are best provided collectively. For example, in Britain, the National Health Service has provided excellent comprehensive healthcare, free at the point of use, for many decades. It provides a better service at a lower cost than many insurance-based systems, and at around half of the cost of the disastrous free-wheeling market that is US healthcare.7

    Free-marketeers see a basic income as the perfect excuse for their wet dream of an antisocial state; introduce it in place of public services, and abandon the rest to the market

    The same goes for housing. Public investment can provide good quality housing in much larger quantities than the private sector.8Subsidizing accommodation in the private rental sector is more expensive than providing state housing and encourages private landlords to inflate their rents. A ‘basic income’ risks a similar effect.9 And, crucially, in an unregulated private market there is little security for most people in that vital thing – home.
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  9. When Greeks lose their jobs, they have a grace period of one year: they'd better find another job within that period, because if they don't they are out of health insurance. If they fall sick, they have to come up with something, or die.

    It's not just Greeks. It turns out in every European Union countries but the United Kingdom and Italy, employment is a pre-requisite for access to health care. But Greece was hit hardest by the 2008 crisis: many more people than elsewhere have turned into long-term unemployed. Everyone is struggling: “We had poor people ten years ago, too – shrugs Maria, a psychologist volunteering at MCCH – but at that time people could fall back on their families, or their neighbors, for help. Not anymore: their families and neighbors are themselves in trouble, and there's little they can do. People are getting desperate.”

    In 2011, some senior doctors started comparing notes, and they saw a perfect health care storm brewing at the horizon. “We knew something very bad was coming, and people would die – says Maria – so we decided we must do something.”
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  10. High income countries such as Sweden, the Netherlands, the UK and Spain have managed to stabilise their incidence of dementia by changing the way they approach mental and physical health in early to mid-life.

    They modified how they deal with dementia risk factors. These include their diets, smoking, depression, physical inactivity, lack of sufficient cognitive stimulation and risk of non-communicable diseases such as diabetes and hypertension.

    Africa, however, is likely to see a rise in dementia over the next decades. This is for two reasons: its ageing population, an increase in non-communicable diseases and the effects of the HIV pandemic.

    Worldwide, there’s an estimated 47 million people living with dementia with 10 million new cases diagnosed each year. The latest Alzheimer’s Disease International report predicts that by 2050, there will be 130 million people living with dementia. About 70% of those people will be from low and middle income countries.
    Tags: , , by M. Fioretti (2016-11-19)
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