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Wednesday, Jul 6 2016

Full Issue

Viewpoints: Hospitals Should Reveal Medical Errors; FDA Takes Time On Muscular Dystrophy Drug That Patients Don't Have

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

Medical errors, by one count, are the third-leading cause of death for Americans. Surgery mistakes, misuse of drugs or equipment, delays in treatment and the like kill at least 100,000 a year, possibly as many as half a million. No one knows the exact number, and that points up an underlying problem: Hospitals almost universally resist confessing when a medical error hurts or kills a patient, because admitting fault can expose them to lawsuits. (7/5)

The Food and Drug Administration is sitting on a therapy for Duchenne muscular dystrophy, and the agency may have days to waste but the boys don鈥檛. Bureaucratic malpractice on a safe and effective treatment is corroding the agency鈥檚 scientific credibility and the public鈥檚 trust. FDA in May delayed a decision on eteplirsen by Boston-based Sarepta Therapeutics. There is no treatment for Duchenne, a fatal disease that claims a boy鈥檚 ability to walk before organ failure in his 20s. Eteplirsen jumps over genetic code to produce a missing protein known as dystrophin. (7/5)

It has been approximately 10 years since well-intended people suggested that medicine change to become more like a business. Presumably, they did so with the intention that health care would improve for both patients and those working in health care. After a decade of medicine in a business mode, we can now assess what changes have occurred with this new paradigm. I don鈥檛 intend on talking about all of them, only those that I feel are the most significant. (Dave Watkin, 7/5)

Last week鈥檚 landmark Supreme Court decision striking down Texas anti-abortion laws has emboldened abortion-rights activists, who now hope to lay waste to abortion restrictions all over the U.S. Their success or failure will depend on whether the Supreme Court proves willing to overhaul its abortion jurisprudence. And that's no sure thing. (Noah Feldman, 7/5)

The U.S. Supreme Court鈥檚 decision to strike down two onerous provisions in a Texas abortion law sends a clear and powerful message that medically unjustified restrictions that obstruct a woman鈥檚 access to abortion are unconstitutional. In its most sweeping decision on abortion since 1992, the court reaffirmed what it said at that time: If a law regulating abortion before the fetus is viable is more an obstacle to women than a benefit to them, then it violates the Constitution. (7/6)

For people in pain, opioids are just one leg of a chair. The other three legs 鈥 which are often missing from the debate on opioid addiction 鈥 can support equal weight if the right medical expertise and infrastructure are in place. The American Society of Anesthesiologists calls this approach multimodal analgesia. It鈥檚 the foundation for my work at Stanford Medical Center and the affiliated VA Palo Alto Health Care System, and for other pain management specialists around the country. It is also part of legislation to be reviewed tomorrow by the House and Senate Opioid Conference Committee. (Michael Leong, 7/5)

My expertise lies in public health, not in finance or investments. However, it is my understanding that in order to reap rewards, one first has to invest. One example is my retirement account. I give up a small amount of money out of each paycheck so that I can experience a secure retirement down the road.This type of thinking can also be applied to the re-energized debate about closing the coverage gap here in Georgia. (Laura Colbert, 7/5)

The administration of Gov. Matt Bevin has gotten very good at blowing up state government-as-it-has-been but the learning curve on picking up the pieces after the explosion is way too slow. The state鈥檚 plan to cut off federal funds the Bluegrass Area Development District administers for aging and independent living services is a case in point. There is every reason to keep a wary eye trained on the Bluegrass ADD. Both its top management and the regional elected officials who oversee it have done little to inspire confidence. Truculent and defensive, they have chosen to spend a ton of money on self-promotion and lawyers rather than settling disputes with their funding source over allegedly misspent funds. (7/5)

Americans seem very afraid of cancer, with good reason. Unlike other things that kill us, it often seems to come out of nowhere. But evidence has increasingly accumulated that cancer may be preventable, too. Unfortunately, this has inflamed as much as it has assuaged people鈥檚 fears. As a physician, I have encountered many people who believe that heart disease, which is the single biggest cause of death among Americans, is largely controllable. After all, if people ate better, were physically active and stopped smoking, then lots of them would get better. This ignores the fact that people can鈥檛 change many risk factors of heart disease like age, race and family genetics. (Aaron E. Carroll, 7/5)

When it was introduced in the late 1920s, Marlboro was a woman鈥檚 cigarette 鈥 鈥淢ild as May,鈥 said the ads. Ads showed glamorous and fashionable young women smoking. Marlboro left the market during the war. But in the 1950s, scientists began associating cigarettes with cancer, and smokers flocked to supposedly safer filtered cigarettes. To combat the view that a filter was for sissies, Philip Morris needed a new, masculine filtered cigarette. The company took Marlboro and fitted it with a filter 鈥 and a cowboy. (Tina Rosenberg, 7/5)

As Haitians were reeling from the devastating Jan. 12, 2010, earthquake, United Nations peacekeepers inadvertently compounded their troubles by bringing cholera to the island. Roughly 10,000 Haitians have died from the disease, which spreads easily in places with poor sanitation. The United Nations hasn鈥檛 acknowledged its responsibility and has vigorously fought legal efforts to secure compensation for victims. This is reminiscent of its slow response to allegations that peacekeepers in Africa had sexually abused scores of minors. (7/6)

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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