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Morning Briefing

Summaries of health policy coverage from major news organizations

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Thursday, Jun 9 2016

Full Issue

Viewpoints: A Judge's 'Bombshell' Finding In Big Pharma Case; Repairing The Broken Mental Health System

A selection of opinions on health care from around the country.

The public doesn鈥檛 have a very high opinion of drug manufacturers for various reasons, and now federal Judge Beth Labson Freeman of San Jose has provided another one. Finding that Merck & Co. lied to a business partner and to the court itself, Freeman this week threw out a patent infringement judgment Merck had won against Gilead Sciences, and overturned a $200-million jury award in the case. This is a big deal, involving one of the most profitable drugs on the market today鈥擥ilead鈥檚 blockbuster Sovaldi treatment for the hepatitis C virus鈥攁nd the world鈥檚 fourth-largest drug company Merck. (Michael Hiltzik, 6/8)

Every day, when I am walking to work, or just walking through the streets of downtown Washington, I encounter homeless people on the street. The homeless cover many categories, but prominent among them are those with serious mental illnesses. They know no boundaries of race or education; there was a prominent story last year in the Washington Post of a homeless man with schizophrenia who told a judge that he didn鈥檛 need a lawyer, that he was a lawyer. When the judge reacted with bemused skepticism, the man informed the judge鈥攁ccurately鈥攖hat they had been in the same class at Harvard Law School. (Norm Ornstein, 6/8)

You鈥檝e got mail. An alert pops up announcing a new message from the portal for my electronic medical record. Previous correspondence had been mundane, but this time I was surprised to receive the results of my recent colonoscopy. I am鈥攐r, until that moment, had considered myself to be鈥攁 healthy person, in surprisingly good condition considering my age and my distaste for exercise, so I was blindsided to receive the pathology report describing in cold clinical terms the abnormal histology of my tissue fragment. The biopsy results suggested an unexpected benign, but chronic, disease. My mind reeled, my self-image collapsed, and suddenly I was alone on a sea of alarm and confusion. Later that day, I was able to speak to my gastroenterologist on the telephone. I expressed to him my surprise at the findings and my dismay at the way I had received the results. I asked whether this had been sent to me by email because I am a physician and thus presumably more capable of understanding the information (which, it turns out, was a false assumption). 鈥淣ot at all,鈥 he replied. 鈥淚t is mandatory that all patients receive biopsy results and lab values within 48 hours.鈥 鈥淲ait,鈥 I replied. 鈥淎ny abnormal biopsy or lab value? Directly to the patient? In an email?鈥 This seemed implausible. (Ellen M. Friedman, 6/7)

When a friend recently finished her grueling year of breast cancer chemotherapy, she received warm congratulations from her health care team and was invited to ring a special bell set up in her doctor鈥檚 office. Another friend, cancer-free for a year, is rewarding herself by taking part in a bike ride fundraising for cancer research. Me? Now that I have been on maintenance chemo for two years, I am celebrating by getting a mammogram. (Marjorie Rosenthal, 6/8)

Whether you make hamburgers, process loans, or take care of patients, fatigue at work leads to errors and mishaps. Among physicians, fatigue can lead to medical errors that may cause great harm. Yet for more than 30 years, the medical profession has been debating limits on how many hours in a row physicians-in-training can work. (Tejal Gandhi and Patricia McGaffigan, 6/8)

More than 1,000 Kentuckians die each year from drug overdoses, more than 200 of them from heroin. Heroin use has surged over the past few years, contributing to drug overdoses becoming a more common cause of death than car accidents in Kentucky. This is a serious public health crisis 鈥 one that must be fought on many fronts at once. (Paul Kensicki, 6/8)

It was roughly halfway into a Saturday evening flight from Miami to Boston when I began to wonder if I was going to survive the night. What had started as a sharp pain on the right side of my abdomen now felt as if my gut were being hacked at with a phalanx of rusty chisels. The only explanation I could think of was that my appendix had burst and I was dying of sepsis. (Seth Mnookin, 6/9)

In this issue of JAMA, Flegal and colleagues1 and Ogden and colleagues2 report updated findings related to the prevalence of obesity in the United States. The news is neither good nor surprising. Using 2013-2014 data from 5455 adults who participated in the National Health and Nutrition Examination Survey (NHANES), 35.0% of men were obese (BMI 鈮30) and 5.5% were morbidly obese (BMI鈮40); among adult women, 40.4% were obese and 9.9% were morbidly obese. These prevalences are unchanged since 2005 among men and represent a slight increase in obesity among women. The data for children are similar. Based on 7017 youth 2 to 19 years old in 2011-2014, the prevalence of obesity was 17.0% and extreme obesity 5.8%. Obesity rates have decreased in children aged 2 to 5 years since 2003-2004, stabilized in 6- to 11-year-olds since 2007-2008, but steadily increased among adolescents since 1988. (Jody W. Zylke and Howard Bauchner, 6/7)

As the 1990s ended, syphilis was on the decline. At least in part due to safer sexual behaviors prompted by the AIDS epidemic,1 the rate of incident syphilis declined to fewer than 4 cases per 100鈥000 by the year 2000, a historic nadir. Eradication of Treponema pallidum infection in the United States seemed quite possible through concentrated public health efforts in a relatively small number of high-incidence US communities, and the Centers for Disease Control and Prevention (CDC) was developing a national syphilis elimination plan.2 Timing seemed auspicious for eradication efforts to be successful. Now, in 2016, hopes for eradication have long since faded, as have many of the gains realized by the effort. Rates of syphilis have trended steadily upward since 2000, and the CDC鈥檚 syphilis elimination efforts officially ended as of December 2013. (Meredith E. Clement and Charles B. Hicks, 6/7)

Growing up in small-town Iowa, I understand the issue of inadequate access to health care and the importance of providing adequate health care to local Iowans. That鈥檚 why I encourage Iowans to support the 鈥淧harmacy and Medically Underserved Areas Enhancement Act鈥 backed by Sen. Chuck Grassley and the entire Iowa delegation. (Taylor Monson, 8/8)

On May 10, 2016, Gov Larry Hogan of Maryland signed into law the Maryland Contraceptive Equity Act of 2016 (MCEA). In so doing, he reaffirmed and extended principles laid down in 1998 by his predecessor, Gov Parris Glendening, when Maryland, a trailblazer in women鈥檚 health care, became the first state in the nation to enact a contraceptive insurance mandate. (Eli Y. Adashi, 6/8)

What we call "Big Fat Industries" 鈥 fast food, soft drink and junk food makers 鈥 have been doing this for years. And they got this strategy from the Big Tobacco playbook. For more than a decade of experience and research in teen tobacco use reduction, followed by a decade working in childhood obesity prevention, I've researched how this all goes back to when Big Tobacco funded studies that claimed cigarettes do not cause lung cancer. (Dewey Caruthers, 6/7)

The battle to contain and ultimately defeat the Ebola epidemic of 2014鈥2015 has been vividly described.1-3 Caught off guard from the start and hindered by myriad coordination, communication, and other problems, a combination of local and international teams fought back with determination, courage, and eventually the deployment of substantial resources to stem the contagion and save lives. Yet more than 11,000 people died, and local economies were brought to a halt. The battle was won, but at immense cost. (Victor J. Dzau and Peter Sands, 6/8)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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