Policy and Ethics

John Ioannidis, a professor at Stanford, has made something of a career writing about the quality of scientific reporting. His paper "Why Most Published Research Findings Are False" is among the most downloaded articles from PLoS Medicine. He has written a new essay in this month’s Social Science and Medicine. He begins with a review of a study in the same issue which demonstrated that unsolicited online reviews of medications were biased. Biased in that a drug’s effectiveness, in this case, Benecol, CholestOff, and Orlistat,

“seemed more impressive in the online reports….The difference between...

As a Californian who also lives in New York City, I am fascinated by how these two states do so many things that cost taxpayers money while producing estimates showing how much we all saved, even though taxes remain really high.

In New York, for example, we are told the state Affordable Care Act program, New York State of Health, saves us all billions, yet for some reason we get 11% of federal money while only having 6% of the enrollees. It's not really a victory for economics when you stay afloat because you get twice as much money as another state. If we were really saving money, that would mean we would instead be able to send money to poor states. 

My other coastal home, California, is saving billions of dollars by penalizing businesses, we were recently told...

Policy decisions should be based on evidence in order to provide the most benefit for the health and safety of the public. However, there are scant guidelines for making sound evidence-based policy focused on the intersection of science and society.

Making science policy requires policymakers, scientists, and the public.

Scientists don't necessarily understand policy and policymakers don't necessarily understand science, and the public, well they may or may not understand either of these two realms. But those three groups bring differing perspectives, understandings, and contexts and each has their set of values that must be integrated to create sound policy. 

The Brussels Declaration on the Ethics and Principles for Science and Society Policy-Making was published...

United Healthcare, the largest provider of Medicare Advantage (MA plans) services, is being sued by the Department of Justice (DOJ) for fraud. To give you a sense of United Healthcare’s size consider that just their third quarter revenue was $46.3 billion, up 11.6 per cent from the same period a year earlier, and the bulk of the growth was billing services and data analysis for healthcare groups, which ws up 34 percent since the beginning of 2016.

And to get a sense of the concern about the DOJ joining a whistle-blower lawsuit, consider this

“...

I hate politics. Is that enough of a disclosure? Well, I hate erosion of the doctor-patient relationship even more, especially when predicated on politicized falsehoods. So without making a political statement, let's have a medical discussion, and you can let me know your thoughts.

A recent ruling by the 11th U.S. Circuit Court of Appeals in Atlanta, Georgia, found the Firearm Owners Privacy Act (FOPA)— enacted in 2011 in Florida— impeded the First Amendment free speech rights of medical professionals. The law sought to preserve Second Amendment rights but thought forbidding physicians to discuss gun ownership with patients was the way to do so. Fines and censure by the state medical board were threatened if doctors were found to be in violation. Ambiguous language didn’t help...

At the end of my senior year in high school, our class opened a time capsule that we made in 2nd grade. Each of us had filled out a piece of paper asking us questions like, "What do you want to be when you grow up?" I wrote "Scientist."

Of course, in 2nd grade, I didn't have a lot of insight into what scientists actually did. (In fact, I didn't truly appreciate it until graduate school.) I thought science was cool. I owned a chemistry set. Whatever science was, I wanted more of it. 

Oddly, the website for the "March for Science," which was organized by scientists, reads a lot like what I wrote in 2nd grade. After weeks of planning, the site's page on Principles and Goals continues to be...

One of the things I miss most about graduate school is access to the library and journals. Researching a topic meant reading primary documents and following the links and references to better understand a discussion or its historical, philosophic or scientific underpinnings. My first response in reading a science article is often to return to primary sources. Primary sources are unfiltered.

But now, with graduate school in the rear view mirror,  when searching for an article I find this.

This presents the difficult decision of whether reading the original is worth the price....

The word "trafficking" does not conjure up pleasant imagery. Human trafficking, drug trafficking, gun trafficking. These are immoral and destructive behaviors. But what about organ trafficking?

According to Catholic News Agency, at the end of a Vatican conference precisely on this topic, participants declared organ trafficking a "crime against humanity." They make a powerful and emotionally persuasive case:

In general, migrants, refugees and the poor are among the most vulnerable populations for organ trafficking, because they may be forced to sell organs if they do not have the cash to pay when soliciting help for...

Some policy issues are so complicated, there appears to be no good or easy solution. Take foreign policy, for example. With nearly 200 countries in the world, each with its own strategic goals and interests, it is nearly impossible either to ensure that everybody gets along or to craft policies that advance American interests while treating everyone else fairly. Deception and communication barriers, such as language and culture, exacerbate the problem. Indeed, statecraft is a job full of contradiction and frustration. 

Not so for energy policy. This is one area in which, if so desired, America could go it alone. Better yet, the solution to America's energy problem would simultaneously solve climate change. That's a win-win. Here's how to do it: 

1. Build...

Obamacare was always about health coverage, not health care. Whatever destiny awaits its future iteration —albeit repeal, replace, repair, what have you, Trumpcoverage would be a better suited name than Trumpcare

If the highest quality of medical care persists in being of unequal consideration to access where continuity of care is permitted to fragment further and individual choice of physician be ever limited, then we all lose no matter the new enactments.   

Whatever your political affiliation, all we hear about from both sides of the aisle are the two aspects of Obamacare that we all desire to keep: not penalizing those with pre-existing conditions and covering young adults under their parents plans until age 26. Bravo to those who...