Headlines: November 6, 2009
by Meg Larkin
Politics and Policy:
As the health care reform debate continues in Washington, a controversy over whether the public option for insurance will fund abortions is coming to the forefront. While most liberal democrats who would oppose the ban on using federal money for abortion are willing to compromise in order to get more conservative democrats on board with health reform overall, the difficult decision of how to structure the ban and whether it will b effective is causing a stir. Reproductive rights groups such as Planned Parenthood oppose the ban because they see it as rolling back a woman’s right to choose. The house is set to vote on the health reform bill this Saturday, but democratic nose-counters have not yet lined up all 218 votes necessary for it to pass through the lower chamber of congress. The legislation has gained the support of powerful lobbies such as the AARP and the American Medical Association this week, and Democrats hope those developments will help them gain the necessary numbers.
While the legislation continues to move forward, some are concerned that the bill is not doing enough to rein in costs. While it does include measures like taxes on high cost insurance plans and limits on fees, it doesn’t reform the health care system in ways that some experts had hoped for. One key omission is a provision that would allow comparative effectiveness research, which would compare leading treatments for a given condition and determine which is most effective at the lowest cost. Additionally Peter Orzag, the White House Budget Chief, has said that the single most important thing that should be done is reforming the tax treatment of employer health benefits.
Research and Diseases:
With concerns about swine flu and flu vaccine shortages are rising, Boston-based law firm Ropes & Gray took matters in to its own hands, stockpiling the antiviral medication Tamiflu. Federal and State health officials have criticized the move because Tamiflu is usually reserved for critical cases of the flu, and most cases of H1N1 are less severe. Some are concerned that widespread use of the antiviral medication by businesses like Ropes & Gray will lead to an antiviral-resistant strain of the H1N1 virus and a shortage of the medication for patients who truly need it. New York City health officials have defended their distribution of swine flu vaccine to large companies such as Citibank and Goldman Sachs by saying that while the focus is to get the vaccine to pediatricians, those companies are entitled to the vaccine if they distribute it to at risk populations within their workforce.
With the cold and flu season knocking at the door, the nation is facing a shortage of the regular seasonal flu vaccine in addition to the H1N1 vaccine. Concerns over the swine flu pandemic have also increased consumers’ concerns about the seasonal flu, leading to demand that is above what vaccine manufacturers can produce in a season. There is a continuing shortage of the H1N1 vaccine that lawmakers now say will extend well into December and possibly in to the new year. For cat lovers there is more to worry about because this week saw the first feline case of swine flu. The cat has recovered, but it is suspected to have caught the virus from someone in its household who was infected with the H1N1 virus. The feline swine flu case has lead veterinarians to remind pet owners to monitor their pet’s health as well as their own during the cold and flu season.
A recent study has shown that text messaging teenage liver transplant recipients reminding them to take their medications can improve adherence to medical advice and reduce the risk of rejection. It is often difficult to get teenagers to comply with doctors’ instructions, but by reaching teenagers on their cell phones doctors were able to help them take better care of their transplants and their health. In other medical news, a study has found that physicians are overusing pap smears, a test for cervical cancer. While it is important for certain groups of women to get screened, doctors are using the test more often than is recommended by American Cancer Society guidelines. Defibrillators, implants that can help restore an arrhythmic heart to a normal beat, may also be overused. Although an agreement between Medicare and the device’s manufacturer was supposed to result in a study that would identify which patients would benefit. While Medicare continues to pay for half of the costly implants, the device manufacturers have not continued to fund the study beyond their initial investment, so it is still unclear which patients truly benefit from the device. In other heart-related news, a study in the New England Journal of Medicine has found that traditional bypass surgery is actually better for patients in the long term than off-pump surgery. Currently about 20 percent of bypass surgeries are done off pump, and while doctors who have specialized in the procedure say they won’t be going back to traditional bypass surgery, the study may influence patient choices.
In the research field, gene therapy may be poised for a resurgence. While it was haunted by catastrophic side effects in the past, three recent successes have made some researchers hopeful that it will be able to help patients with formerly devastating conditions. However, some including Stanford gene therapy researcher Dr. Mark Kay advocate cautious optimism. In international news, decreased funding by international donors is limiting the ability of organizations committed to fighting AIDS to meet the needs of the communities they serve. Decreased funding is also hurting programs that fight tuberculosis and malaria.
Meg Larkin is a second year student at Boston University School of Law. Any comments, questions, or suggestions are welcome via email.