Policy and Ethics

The World Health Organization (WHO) is one of the finest institutions on the planet. Its accomplishments are far too numerous to list here, but its most famous is the effort it led to eradicate smallpox from the face of the planet. It is not an exaggeration to say that the WHO's missions have saved hundreds of millions of lives.

Because of such successes, something like a halo surrounds whatever the WHO chooses to do. But that's not healthy. No matter how well-meaning and righteous an organization is, it requires oversight. Without it, mismanagement and even corruption can creep in. 

According to the ...

Can someone please explain the logic here? Does this make any sense at all?

You are looking at a well-organized protest aimed at Pfizer (1) for not having any Bicillin L-A (aka penicillin G, or just Bicillin) to sell. Bicillin is the drug of choice for the treatment of syphilis, a sexually transmitted infection that has become much more prevalent in the past decade, especially among gay men (2), but in other populations. There is only one way to catch syphilis—by having sex with someone who already has it. Although condom use will help prevent it, it has been estimated that condoms offer protection...

“Patients have long been aware that many unseen dollars drive medical decisions and events.”

 

Introduction

Since the first time exchange of a chicken for medical care, there have been conflicts of interest, real or imagined, between “self-interest" and "altruism.” Recently JAMA devoted an entire issue to conflicts of interest (COI) in healthcare, within the healthcare community as well as for physicians facing outward, towards our patients.

Before summarizing those outward facing articles [1], consider the underlying problem of the dilemma between patient and doctor.

The patient, the person with a need, employs...

Medical bills are difficult to understand that makes pricing transparency an impossible dream. Here is a common sense guide to understanding these bills, especially for the uninitiated or those that see them only occasionally. It's hopefully a Rosetta Stone, but some aspects of pricing will remain mystical.

Charges: The Imaginary Numbers Of Health Care - this is the amount that your doctor or hospital is charging. It is an imaginary number (for the mathematically inclined like the square root of -1) but is frequently presented as a specific number like $300.75, suggesting that there was a significant degree of mathematical precision involved in its determination.

Don't believe it.

Physicians learn to set prices by talking to their peers or are...

If your only source for news are the idiots at Mother Jones or the even bigger idiots at Sourcewatch, you probably don't know much about the real American Council on Science and Health. Instead, you believe their manufactured claims that we are some kind of sinister organization because we want to give Americans real answers about science and health.

When I bother to read their stuff I am hardly surprised to find that I, along with our other scientists and doctors:

  • Help industry pollute our air and water
  • Feed harmful chemicals to babies, like pesticides.
  • Brainwash otherwise-healthy people into buying and taking poisonous drugs and vaccines.

Most of their claims about us are tired old conspiracy theories (i.e. if you are pro-science, you...

The US House of Representatives, in its quest to "repeal and replace" the Affordable Care Act (aka Obamacare), has included in its effort a proposal to "defund" Planned Parenthood. What does this mean, and who will be affected and how?

First of all, understand that any federal funding that goes to Planned Parenthood is via Medicaid or Title X. There is no budget line that specifically grants Planned Parenthood a certain amount of money. Title X is the federal family planning program that makes grants to a variety of providers of family planning services. This includes two hospital-based clinics, free-standing clinics, 24...

Physicians give advice. That’s what we do.

In doing so, we are required to be unbiased advocates for our patients. We are fiduciaries, to use a term from economics. [1] Life and death issues, especially end of life issues, heighten the gravitas of these moments; and often in those times guidance comes from the family as well as physicians.

Jason Dana and Daylian Cain authored a meta-analysis, Advice versus Choice, that shows the ways that advice given by physicians is biased, intentionally or not. Or as they put it, “A fundamental ethical principle is that we should treat others as we ought to be treated. Yet, what people advise others to do is often different than what they choose for themselves.” The paper...

Dear Hollywood:

Recently, a video of actor and musician Jack Black visiting children admitted to Children's Hospital Los Angeles was viewed by over a million people, even though it was not even on YouTube. It went viral for a reason that gets lost on a lot of publicists, who instead want their clients (you) to be endorsing the right groups, the right political causes, the right things for your brands.

Black instead just showed he cares about sick kids and wanted to Make March Matter, the name of the CHLA outreach campaign. It was a local initiative, it shouldn't have been popular all...

A young man who received a lung transplant four weeks ago following a terrible case of pneumonia that caused his lungs to collapse has died. He is making national headlines because his petition to receive new lungs was initially rejected because he had smoked marijuana.

This will very likely cause outrage, especially since more states are legalizing marijuana. But in a world in which transplantable organs are in short supply, hospitals must make decisions about which patients to prioritize. According to the article, the University of Utah Hospital said:

"Generally speaking, we do not transplant organs in patients with active alcohol...

Several years after the ACA ("Obamacare") passed, healthcare costs continue to rise in America. The question of why – and, perhaps more importantly, how much of these costs should be covered by the government – continue to spark intense political debate.

New research funded by the Gates Foundation and led by Joseph Dieleman of the University of Washington may shed some light on this issue. The researchers investigated global patterns of healthcare spending, and their results are published in The Lancet.

For their investigation, the team analyzed healthcare spending (which was adjusted for inflation and purchasing power) in 184 countries from 1995 to 2014. Then, they conducted regression analyses, with the general aim of making two broad determinations: (1) Given...