When Patients Request Unproven Treatments

Casey Humbyrd and Matthew Wynia
medscape.com
Originally posted March 25, 2019

Here is an excerpt:

Ethicists have made a variety of arguments about these injections. The primary arguments against them have focused on the perils of physicians becoming sellers of "snake oil," promising outlandish benefits and charging huge sums for treatments that might not work. The conflict of interest inherent in making money by providing an unproven therapy is a legitimate ethical concern. These treatments are very expensive and, as they are unproven, are rarely covered by insurance. As a result, some patients have turned to crowdfunding sites to pay for these questionable treatments.

But the profit motive may not be the most important ethical issue at stake. If it were removed, hypothetically, and physicians provided the injections at cost, would that make this practice more acceptable?

No. We believe that physicians who offer these injections are skipping the most important step in the ethical adoption of any new treatment modality: research that clarifies the benefits and risks. The costs of omitting that important step are much more than just monetary.

For the sake of argument, let's assume that stem cells are tremendously successful and that they heal arthritic joints, making them as good as new. By selling these injections to those who can pay before the treatment is backed by research, physicians are ensuring unavailability to patients who can't pay, because insurance won't cover unproven treatments.

The info is here.

Rural hospitals foundering in states that declined Obamacare

Michael Braga, Jennifer F. A. Borresen, Dak Le and Jonathan Riley
GateHouse Media
Originally published July 28, 2019

Here is an excerpt:

While experts agree embracing Obamacare is not a cure-all for rural hospitals and would not have saved many of those that closed, few believe it was wise to turn the money down.

The crisis facing rural America has been raging for decades and the carnage is not expected to end any time soon.

High rates of poverty in rural areas, combined with the loss of jobs, aging populations, lack of health insurance and competition from other struggling institutions will make it difficult for some rural hospitals to survive regardless of what government policies are implemented.

For some, there’s no point in trying. They say the widespread closures are the result of the free market economy doing its job and a continued shakeout would be helpful. But no rural community wants that shakeout to happen in its backyard.

“A hospital closure is a frightening thing for a small town,” said Patti Davis, president of the Oklahoma Hospital Association. “It places lives in jeopardy and has a domino effect on the community. Health care professionals leave, pharmacies can’t stay open, nursing homes have to close and residents are forced to rely on ambulances to take them to the next closest facility in their most vulnerable hours.”

The info is here.

The Gap Between Rich And Poor Americans' Health Is Widening

Susie Neilson
npr.org
Originally posted June 28, 2019

Hereis an excerpt:

The researchers looked at differences in health between white and black people and between three income brackets. They assessed the degree to which race, income and gender influenced health outcomes over time, a measure they called "health justice."

Finally, they calculated the gap between people's health outcomes and that of the most privileged demographic: high-income white men.

"Results of this analysis suggest that there has been a clear lack of progress on health equity during the past 25 years in the United States," the researchers write.

Income was the biggest predictor of differences in health outcomes, according to Zimmerman. Health differences between the highest income group and lowest income group increased "really quite dramatically," he says.

Things weren't all negative. On one measure — disparity between health outcomes for black and white people — the gap between health outcomes narrowed significantly.

But gender and race still influenced health outcomes.

Lisa Cooper, a Bloomberg distinguished professor in health equity at Johns Hopkins University, called the study's conclusions "frustrating, but honestly not surprising."

The info is here.