KFF Health News

KFF Health News' 'What the Health?': A Not-So-Health-y GOP Debate

The Host

Julie Rovner
KFF Health News


@jrovner


Read Julie's stories.

The Host

Julie Rovner
KFF Health News


@jrovner


Read Julie's stories.

Julie Rovner is chief Washington correspondent and host of KFF Health News’ weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.

For the first time since 2004, it appears health insurance coverage will not be a central issue in the presidential campaign, at least judging from the first GOP candidate debate in Milwaukee Wednesday night. The eight candidates who shared the stage (not including absent front-runner Donald Trump) had major disagreements over how far to extend abortion restrictions, but there was not even a mention of the Affordable Care Act, which Republicans have tried unsuccessfully to repeal since it was passed in 2010.

Meanwhile, a new poll from KFF finds that health misinformation is not only rampant but that significant minorities of the public believe things that are false, such as that more people have died from the covid vaccine than from the covid-19 virus.

This week’s panelists are Julie Rovner of KFF Health News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Victoria Knight of Axios, and Margot Sanger-Katz of The New York Times.

Panelists

Joanne Kenen
Johns Hopkins Bloomberg School of Public Health and Politico


@JoanneKenen


Read Joanne's stories

Victoria Knight
Axios


@victoriaregisk


Read Victoria's stories

Margot Sanger-Katz
The New York Times


@sangerkatz


Read Margot's stories

Among the takeaways from this week’s episode:

  • The first Republican presidential debate of the 2024 cycle included a spirited back-and-forth about abortion, but little else about health care — and that wasn’t a surprise. During the primary, Republican presidential candidates don’t really want to talk about health insurance and health care. It’s not a high priority for their base.
  • The candidates were badly split on abortion between those who feel decisions should be left to the states and those who support a national ban of some sort. Former Vice President Mike Pence took a strong position favoring a national ban. The rest revealed some public disagreement over leaving the question completely to states to decide or advancing a uniform national policy.
  • Earlier this summer, Stanford University’s Hoover Institute unveiled a new, conservative, free-market health care proposal. It is the latest sign that Republicans have moved past the idea of repealing and replacing Obamacare and have shifted to trying to calibrate and adjust it to make health insurance a more market-based system. The fact that such plans are more incremental makes them seem more possible. Republicans would still like to see things like association health plans and other “consumer-directed” insurance options. Focusing on health care cost transparency could also offer an opportunity for a bipartisan moment.
  • In a lawsuit filed this week in U.S. District Court in Jacksonville, two Florida families allege their Medicaid coverage was terminated by the state without proper notice or opportunity to appeal. It seems to be the first such legal case to emerge since the Medicaid “unwinding” began in April. During covid, Medicaid beneficiaries did not have to go through any kind of renewal process. That protection has now ended. So far, the result is that an estimated 5 million people have lost their coverage, many because of paperwork issues, as states reassess the eligibility of everyone on their rolls. It seems likely that more pushback like this is to come.
  • A new survey released by KFF this week on medical misinformation found that the pandemic seems to have accelerated the trend of people not trusting public health and other institutions. It’s not just health care. It’s a distrust of expertise. In addition, it showed that though there are people on both ends — the extremes — there is also a muddled middle.
  • Legislation in Texas that was recently signed into law by Republican Gov. Greg Abbott hasn’t gotten a lot of notice. But maybe it should, because it softens some of the state’s anti-abortion restrictions. Its focus is on care for pregnant patients; it gives doctors some leeway to provide abortion when a patient’s water breaks too early and for ectopic pregnancies; and it was drafted without including the word “abortion.” It bears notice because it may offer a path for other states that have adopted strict bans and abortion limits to follow.

Plus, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too:

Julie Rovner: KFF Health News’ “Doctors and Patients Try to Shame Insurers Online to Reverse Prior Authorization Denials,” by Lauren Sausser.

Margot Sanger-Katz: KFF Health News’ “Life in a Rural ‘Ambulance Desert’ Means Sometimes Help Isn’t on the Way,” by Taylor Sisk.

Joanne Kenen: The Atlantic’s “A Simple Marketing Technique Could Make America Healthier,” by Lola Butcher.

Victoria Knight: The New York Times’ “The Next Frontier for Corporate Benefits: Menopause,” by Alisha Haridasani Gupta.

Also mentioned in this week’s episode:

Click to open the transcript

Transcript: A Not-So-Health-y GOP Debate

[Editor’s note: This transcript, generated using transcription software, has been edited for style and clarity.]

Julie Rovner: Hello and welcome back to “What the Health?” I’m Julie Rovner, chief Washington correspondent for KFF Health News. And I’m joined by some of the best and smartest health reporters in Washington. We’re taping this week on Thursday, Aug. 24, at 10 a.m. As always, news happens fast, and things might have changed by the time you hear this. So, here we go. We are joined today via video conference by Margot Sanger-Katz of The New York Times.

Margot Sanger-Katz: Good morning.

Rovner: Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico.

Joanne Kenen: Hi, everybody.

Rovner: And Victoria Knight of Axios News.

Victoria Knight: Hello, everyone.

Rovner: No interview this week, but we’ll have an entire interview episode next week. More on that later. First, we will get to this week’s news. Well, Wednesday night saw the first Republican presidential debate of the 2024 cycle, minus front-runner Donald Trump, in what could only be called a melee, on Fox News Channel. And while there was a spirited debate about abortion, which we’ll get to in a minute, I didn’t hear a single word about anything else health-related — not Medicare or Medicaid, nor any mention of the Affordable Care Act. Was anybody surprised by that? For the record, I wasn’t. I wasn’t really expecting anything except abortion.

Kenen: Well, somebody, I think it was [former New Jersey Gov. Chris] Christie actually pointed out that nobody was talking about it.

Knight: Mike Pence. It was [former Vice President] Mike Pence, actually.

Kenen: Oh, Pence. OK. “Nobody’s talking about Medicare and Social Security.” And then he didn’t talk about it, and nobody mentioned the ACA.

Rovner: Is the ACA really gone as a Republican issue, for this cycle, do we think?

Kenen: Well, I think it’s become, like, a guerrilla warfare. Like, they’re still trying to undermine it. They’re not trying to repeal it, but they’re looking at its sort of soft underbelly, so to speak, and trying to figure out where they can put more market forces on, which we can sort of come back to later. But they spent 10 years trying to repeal it, and they just figured out what they’ve got to do now is pretend it’s not there. Right now, abortion is their topic.

Rovner: Well, let us turn to that.

Sanger-Katz: Yeah, I was just going to say that we’ve been seeing this happen a little bit over the last couple of cycles. In the 2020 race — I went through the transcripts of all of the speakers during the Republican National Convention and was really staggered by how few mentions of Obamacare there were relative to the way that the issue had been discussed in the past. But I think — just a note, that this is the Republican debate. Republicans don’t really want to be talking about health insurance and health care, because they don’t really have affirmative plans to put forward and because I think that they see that there are some real political liabilities in staking out a strong position on these issues. But in a general election, I think it will be impossible for them to avoid it, because, I think, Joe Biden has a lot of things that he wants to say. I think he is very committed to, in particular, broadcasting that he wants to protect Medicare. I think he’s quite proud of the expansions that he’s made of the Affordable Care Act. And so, this is a little bit of a weird moment in the race because, you know, we really only have one party that’s having a primary, and its leading candidate is not participating in the debates. And so, I think these candidates are trying to focus elsewhere. But it is — I will say, as someone who’s covered a couple of these now — it is a weird experience to have health care and health policy feel like a second-tier issue, because it was so central — Obamacare, in particular — was just so central to so many of these election cycles and such an animating and unifying issue among Republican voters, that this kind of post-failure-of “repeal and replace” era feels very different.

Kenen: One really quick thing is, they’re going to hit Biden on inflation. Economically, it’s his most vulnerable point, and health care costs are a burden. And I was a little surprised, without going into Obamacare and repeal and all that stuff, they mentioned the price of food, the price of gas, they mentioned interest rates and housing. It would have been really easy, and I expect that at some point they will start doing it, to talk about the cost of health care, because Biden’s done a huge amount on coverage and making insurance more affordable and accessible. But the cost of health care, as we all know, is still high in America.

Rovner: And at very least, the cost of prescription drugs, which has been a bipartisan issue going back many, many years. All right. Well, the one health issue that, not surprisingly, did get a lot of attention last night was abortion. With the exception of Mike Pence, who has been an anti-abortion absolutist for his entire tenure in Congress, as governor of Indiana, and as vice president, everyone else looked pretty uncomfortable trying to walk the line between the very anti-abortion base of the party and the recognition that anti-abortion absolutism has been a losing electoral strategy since the Supreme Court overturned Roe last year. What does this portend for the rest of the presidential race and for the rest of the down-ballot next year? Rather than trying to bury the fact that they all disagree, they all just publicly disagreed?

Knight: And I think they also, like, if you listened, [former U.S. ambassador to the United Nations] Nikki Haley kind of skirted around how she would address it. She talked about some other things, like contraception and saying that there just weren’t enough votes in the Senate to pass any kind of national abortion ban. [Florida Gov.] Ron DeSantis also, similarly, said he was proud of his six-week bill but didn’t quite want to answer about a national abortion ban. There were the few that did say, like, Hey, we’re into that. And some said, You know, it needs to go back to the states. So there definitely was kind of this slew of reactions on the stage, which I think just shows that the Republican Party is figuring out what message, and they don’t have a unified one on abortion, for sure.

Rovner: I do want to talk about Nikki Haley for a second, because this is what she’s been saying for a long time that she thinks that there’s a middle ground on abortion. And, you know, bless her heart. I’ve been covering this for almost 40 years and there has never been a middle ground. And she says, well, everybody should be for contraception. Well, guess what? There’s a lot of anti-abortion stalwarts who think that many forms of contraception are abortion. So there isn’t even a consensus on contraception. Might she be able to convince people that there could be a middle ground here?

Sanger-Katz: Oh, what I found sort of interesting about her answers: I think on their face they were kind of evasive. They were like, I don’t need to answer this question because there’s not a political consensus to do these things. But I do think it was sort of revealing of where the political consensus is and isn’t that I think she’s right. Like, realistically, there aren’t the votes to totally ban abortion; there aren’t the votes to renew the Roe standard. And I think she was in some ways very honestly articulating the bind that Republicans find themselves in, where they, and I think a lot of their voters, have these very strong pro-life values. At the same time, they recognize that getting into discussions about total abortion bans gives no favors politically and also isn’t going to happen in the near future. So, I felt like, as a journalist, you know, thinking about how I would feel having asked her that question, I felt very dissatisfied by her answer, because she really didn’t answer what she would like to do. But I do think she channeled the internal debate that all these candidates are facing, which is, like, is it worth it to go all the way out there with a policy that I know will alienate a lot of American voters when I know that it cannot be achieved?

Rovner: I was actually glad that she said that because I’ve been saying the opposite is true also — everybody says, well, why didn’t, you know, Congress enshrine abortion rights when they could have? The fact is, they never could have. There have never been 60 votes in the Senate for either side of this debate. That’s why they tried early after Roe to do national bans and then a constitutional amendment. They could never get enough votes. And they tried to do the Freedom of Choice Act and other abortion rights bills, and they couldn’t get those through either. And this is where I get to remind everybody, for the 11,000th time, the family planning law, the Title X, the federal Family Planning [Services and Public Research] Act, hasn’t been reauthorized since 1984 because neither side has been able to muster the votes even to do that. Sorry, Joanne, you wanted to say something.

Kenen: No, I thought Haley’s response on abortion was actually really pretty interesting on two points, right? She didn’t technically answer the question, but she also said this question is a fantasy — you know, face it. And, you know, she said that, and then she mentioned the word contraception. She did not dwell on it. She sort of said it sort of quickly. She missed an opportunity, maybe, just for one or two more sentences. You know, she said we need to make sure that contraception … she’s the only woman on that stage. She’s a mother; she’s got two kids. And, you know, there is uncertainty. After Dobbs there were advocacy groups saying, you know, they’re going to ban contraception tomorrow, and that didn’t happen. And we still don’t know how that fight will play out and what types of contraception will be debated. But I noticed that she said that on a stage full of Republicans, and I noticed that nobody else — all men — didn’t pick up on it.

Rovner: The big divide seemed to be, do you want to leave it completely to the states or do you want to have some kind of national floor of a ban? And they seemed, yeah —

Kenen: Yeah, and the moderators didn’t pick up on that. I mean, there was such a huge brouhaha on the stage. You know, the moderators had a lot of trouble moderating last night. It wouldn’t have been easy for them to get off of abortion and follow up on contraception. But I thought it was just sort of an interesting thing that she noted it.

Sanger-Katz: I will say also, and I agree with Julie: With the possible exception of Mike Pence, even the candidates that were endorsing some kind of national abortion policy, we’re talking about a 15-week gestational limit. There really wasn’t anyone who was coming out and saying, “Let’s ban all abortions. Let’s even go to six weeks,” which many of the states, including Florida, have done. So I do think, again, like, even the candidates that were more willing to take an aggressive stand on whether the federal government should get involved in this issue were moderating the position that you might have expected for them before Dobbs.

Kenen: But even 15 weeks shows how the parameters of this conversation have changed, because what the Republicans had been doing pre-Dobbs was 20 weeks, with their so-called fetal-pain bills. So 15 weeks, which would have sounded extremely radical two years ago — compared to six weeks, 15 sounds like, oh, you know, this huge opportunity for the pro-choice people. And it is another sign of how this space has shrunk.

Sanger-Katz: Yeah, no, I don’t mean that it’s a huge opportunity for the pro-choice people, but I think it reflects that even the candidates who were willing to go the most out on the limb in wanting to enforce a national abortion restriction understand the politics do not permit them to openly advocate going all the way towards a full ban.

Rovner: While we are on the subject of Republicans and health, there actually is a new Republican plan to overhaul the health system. Sort of. It’s from the Hoover Institution at Stanford, from which a lot of conservative policy proposals emanate. And it’s premised on the concept that consumers should have better control of the money spent on their health care and a better idea of what things cost. Now, this has basically been the theme of Republican health plans for as long as I can remember. And the lead author of this plan is Lanhee Chen, who worked for Republicans in the Senate and then led presidential candidate Mitt Romney’s policy shop, and whose name has been on a lot of conservative proposals. But I find this one notable more for its timing. Republicans, as we mentioned, appear to have internalized the idea that the only thing they can agree on when it comes to health care is that they don’t like the Affordable Care Act. Is that changing or is this just sort of hope from the Republican side of the policy wonk shop?

Sanger-Katz: I think this is connected to the discussion that we had about the debate, but it feels to me like we are in a bit of a post Obamacare era where the fights about “Are we going to continue to have Obamacare or not?” have sort of faded from the mainstream of the discussion. But there’s still plenty of discussion to be had about the details. The Democrats clearly want to expand Obamacare in various ways. Some of those they have done in a temporary fashion. Others are still on the wish list. And I think this feels very much like the kind of calibration adjustment, you know, small changes, tinkers on the Republican side to try to make the health insurance market a little bit more market-based. But this is not a big overhaul kind of plan. This is not a repeal-and-replace plan. This is not a plan that is changing the basic architecture of how most Americans get their insurance and how it is paid for. This is a plan that is making small changes to the regulation of insurance and to the way that the federal government finances certain types of insurance. That said, I think the fact that it’s more incremental makes it feel like these are things that are more likely to potentially happen because they feel like there are things that you could do without having a huge disruptive effect and a big political backlash and that you could maybe develop some political consensus around.

Rovner: It does, although I do feel like, you know, this is a very 2005 plan. This is the kind of thing that we would have seen 15 years ago. But as Democrats have gotten the Affordable Care Act and discovered that the details make it difficult, Republicans have actually gotten a lot on the transparency side and, you know, helping people understand what things cost. And that hasn’t worked very well either. So there’s a long way to go, I think, on both sides to actually make some of these things work. Victoria, did you want to add something?

Knight: Yeah, I’ve been talking to Republicans a lot, trying to figure out like what is their next go-to going to be. And I think they’re pretty understanding that ACA is set in place, but they still don’t want to give up that there are alternative types of health insurance that they want to put out there. And I think that seems that’s kind of what they realize they can accomplish if they get another Republican president and they’re going to try to do association health plans again. They’re going to try to expand some of these what they call health reimbursement arrangements, things like that, to just like kind of try to add some other types of health insurance options, because I think they know that ACA is just too entrenched and that there’s not much else they can do outside of that. And then, yeah, I think focus a little more on the transparency and cost because they know that’s a winning message and that is the one thing in Congress right now on the health care end that seems to have bipartisan momentum for the most part.

Rovner: Yeah, I think you’re absolutely right. Well, another issue that could have come up in last night’s debate but didn’t was the unwinding of Medicaid coverage from the pandemic. The news this week is that the first lawsuit has been filed accusing a state of mistreating Medicaid beneficiaries. The suit filed against Florida by the National Health Law Program and other groups is on behalf of two kids, one with a disability, and a mom who recently gave birth. All would seem to still be eligible, and the mom says she was never told how to contest the eligibility determination that she was no longer eligible, and that she was cut off when she tried to call and complain. State officials say their materials have been approved by the Centers for Medicare & Medicaid Services, which they have, and that Florida, in fact, has a lower procedural disenrollment rate than the average state, which is also true. But with 5 million people already having been dropped from Medicaid, I imagine we’re going to start to see a little more pushback from advocacy groups about people who are, in all likelihood, still eligible and have been wrongly dropped. I’m actually a little surprised that it took this long.

Kenen: Many of the people who have been dropped, if they’re still eligible, they can get recertified. I mean, there’s no open enrollment season for Medicaid. If you’re Medicaid-eligible, you’re Medicaid-eligible. The issue is, obviously, she didn’t understand this. It’s not being communicated well. If you show up at the hospital, they can enroll you. But people who are afraid that they aren’t covered anymore may be afraid of going to the hospital even if they need to. So there’s all sorts of bad things that happen. In some of these cases, there are simple solutions if the person walks in the door and asks for help. But there are barriers to walking in the door and asking for help.

Rovner: I was going to say one of the plaintiffs in this lawsuit is a child with a disease …

Kenen: Cystic fibrosis.

Rovner: Right. That needs expensive drugs and had not been able to get her drugs because she had been cut off of Medicaid. So there’s clearly stuff going on here. It’s probably true that Florida is better than the average state, which means that the average state is probably not doing that well at a lot of these things. And I think we’re just starting to see, you know, it’s sort of mind-numbing to say, oh, 5 million people have been separated from their health insurance. And again, we have no idea how many of those have gotten other health insurance, how many of those don’t even know and won’t know until they show up to get health care and find out they’re no longer covered. And how many people have been told they’re no longer covered but can’t figure out how to complain and get back on?

Sanger-Katz: And it’s this very extreme thing that’s happening right now. But it is, in many ways, the normal system on steroids. You know, if you’ve been covering Medicaid for any period of time, as all of us have, like, people get disenrolled all of the time from Medicaid for these administrative reasons, because of some weird hiccup in the system, they move, their income didn’t match in some database. This is a problem that a lot of states face because they have financial incentives often to drop people off of Medicaid because they have to pay a portion of the cost of providing health care. And a lot of them have rickety systems, and they’re dealing with a population that often has unstable housing or complicated lives that make it hard for them to do a lot of paperwork and respond to letters in a timely way. And so part of the way that I’ve been thinking about this unwinding is that there’s a particular thing that’s happening now, and I think there’s a lot of scrutiny on it, appropriately. And I think that there should be to make sure that the states are not cutting any corners. But I also think in some ways it’s sort of like a way of pressure-testing the normal system and reminding us of all of the people who slip through the cracks in normal times and will continue to do so after this unwinding is over. And these stories in Florida, to me, do not feel that dissimilar from the kinds of stories that I have heard from patients and advocates in states long before this happened.

Rovner: Yeah, I think you’re right. It’s just shining a light on what happens. I mean, it was the oddity that they were … states were not allowed to redetermine eligibility during the pandemic because normally states are required to redetermine eligibility at least once a year. And I think some do it twice a year. So it’s, you know, these redeterminations happen. They just don’t happen all in a huge pile the way they’re happening now. And I think that’s the concern.

Sanger-Katz: And it also, I think, really shines a light on the way that Medicaid is structured, where the Affordable Care Act simplified it quite a lot because, [for example], you’re in an expansion state and you earn less than a certain amount of money, then you can get Medicaid. But there are all of these categories of eligibility where, you know, you have to be pregnant, you have to be the parent of a child of a certain age. You have to demonstrate that you have a certain disability. And I think [it] is a reminder that this is a pretty complicated safety net, Medicaid. You know, there’s lots of things that beneficiaries have to prove to states in order to stay eligible. And there’s lots of things, honestly, you know, if states really want to make sure that they are reserving resources for the people who need them, that they do need to be checking on. And so I think we’re all just sort of seeing that this is a messy, complicated process. And I think we’re also seeing that there are these gaps and holes in who Medicaid covers. And it’s not the case that we have a perfect and seamless system of universal coverage in this country. We have this patchwork and people do fall between the cracks.

Kenen: And this is one of the most vulnerable populations, obviously. Some of the elderly are also very vulnerable, but these are people who may not speak either English or Spanish. They don’t have access to computers necessarily. I mean, we’re giving the least assistance to the population that needs the most assistance. And, you know, I mean, I think if Biden wanted to be really savvy about fixing it, he’d come out with some slogan about “Instead of Medicare unwinding, it’s time to have Medicare rewinding,” or something like that, because they’re going to have to figure … I mean, they have taken some steps, but it’s a huge mess, and the uninsurance rate is going to go up, and hospitals are going to have patients that are no longer covered, and it’s not going to be good for either the health care system or certainly the people who rely on Medicaid.

Rovner: I think it’s noteworthy how much the administration has been trying not to politicize this, that apparently, you know, we keep hearing that they won’t even tell us which states, although you can … people can sort of start to figure it out. But, you know, states that are having a more difficult time keeping eligible people on the rolls, shall we say, when the administration could have … I mean, they could be trumpeting, you know, which states are doing badly and trying to shame them. And they are rather very purposely not doing that. So I do think that there’s at least an attempt to keep this as collegial, if you will, as possible in a presidential election year. So my colleagues here at KFF have a depressing, but I guess not all that surprising, poll out this week about medical misinformation and how much of the public believes things that simply aren’t true — like that more people died from the covid vaccine than covid itself, or that ivermectin is a useful treatment for the virus. It’s not. It’s for parasites. And the survey didn’t just ask about covid. People have been exposed to, and a significant percentage believe, things like that it’s harder to get pregnant if you’ve been on birth control and stop. It isn’t. Or that people who keep guns in their house are less likely to be killed by a gun than those who don’t. They’re not. But what’s really depressing is the fact that the pandemic seems to have accelerated an already spiraling trend in distrust of public institutions in general: government, local and national media, and social media. Are we ever going to be able to start to get that back? I mean, you know, we talk about the woes with public health, but this goes a lot deeper than that, doesn’t it?

Kenen: And it’s not just health care. When you look at historical metrics about trust — which I’ve had to for a course I teach — we were never a very trusting society, it turns out. We’ve had large sectors of the population haven’t been trusting of many institutions and sectors of society for decades. We’re just not too huggy in this country. It’s gotten way worse. And what you said is right, but it’s broad. It’s not just doctors. It’s not just vaccines, it’s expertise. This distrust is really corrosive. But of all the things in that survey, one that really blew me away was we’re like, what, 13 years since Obamacare was passed? Only 7% or 8% — “only,” I should say only in quotes, you know — only 7% or 8% still thought there were death panels, but something like 70% wasn’t sure if there were death panels. Like, has anyone known anyone who went before a death panel? Since 2010? And yet 70% — I mean, I may be a little off, I didn’t write it down — but it’s something like 70% weren’t sure. And that is a mind-blowing number. It just says, you know, they weren’t ready to come out and say, yes, there are death panels. But that meant that a lot of Democrats also weren’t sure if there were death panels There are no death panels.

Knight: I was just gonna say, I also thought it was interesting that it showed people do use social media to get a lot of their information, but then they also don’t trust the information that they get on there. So it’s kind of like, yeah …

Rovner: And they’re right not to!

Knight: Yeah, they’re absolutely right not to. But then it’s also like, well, they’re then just not getting health information at all, or if they’re getting it, they just don’t trust it. So just showcasing how difficult it is to fill that void of health information, like, people just aren’t getting it or don’t trust it.

Rovner: I feel like some of this is social literacy. I mean, you know, we talk about health literacy and things that people can understand, but, you know, people don’t understand the way journalism works, the difference between the national news and what you see on Facebook. And I think that’s, Joanne, going back to your point about people not trusting expertise, it’s also not being able to figure out what expertise is and who has expertise. I mean, that’s really sort of the bottom line of all this, isn’t it?

Kenen: Well, I mean, I was doing some research — I can’t remember the exact details, this was something I read several months ago — but there was one survey maybe a couple of years ago where the majority of people said they don’t trust the news they read, but they’re still getting their news from something that they don’t trust. So it sounds sort of funny, but it’s actually not. I mean, it’s really a crisis of people don’t know what to believe. The uncertainty is corrosive, and it’s health care and politics, this widening chasm of people with alternative sets of facts — or alternative worldviews, anyway. So it’s not good. I mean, it was a really good survey, it was a really interesting survey, but some of it wasn’t so surprising. I mean, that there’s still people who, like, the fertility issues and the vaccines. You can sort of understand why those have lingered in the environment we’re in. I had actually had a conversation the other day with a political scientist who had studied the death panel rumors 10 years ago. And I said, what about now? And, you know, he was sort of … he hadn’t looked at it and he was sort of saying, well, you know, there aren’t any. And people have probably figured that out by now. Well, no. I have to email him the study, right?

Sanger-Katz: Anytime that I read a study like this, I am also reminded — and I think it is useful for all of us to be reminded of this and probably most people who are listening to the podcast — that the average American is just not as tuned in on the news and on the Washington debate and on the minutia of public policy, as all of us are. So, you know, and I think that that is part of the reason why you see so many people not sure about these things. It’s clearly the case that they are being exposed to bad information and that is contributing to their uncertainty. And I think the rise of misinformation about both health policy and about actual, you know, health care, in the case of covid, is a bad and relatively newer phenomenon. But I also think a lot of people just aren’t paying that close attention, you know, and it’s good to be reminded of that.

Kenen: The book I just read that I referred to — it’s by an MIT political scientist named Adam Berinsky, and it’s called “Political Rumors.” And it just came out, and he was talking about exactly that, that we’re all exposed to misinformation. We can’t avoid it. It’s everywhere. And that for people who aren’t as engaged with day-to-day politics, they end up uncertain. That’s this messy middle, which they also use in the KFF survey. They came up with a very similar conclusion about the “muddled middle,” I think was the phrase they used. And what this political scientist said to me the other day was that, you know, pollsters tend to not look at the “I don’t know, I’m uncertain, no opinion.” They sort of shunt them aside and they look at the “yes” or “no” people. And he was saying, no, no, no, you know, this is the population we really need to pay attention to, the “Uncertains” because they’re probably the ones you can reach more. And in the real world, we saw that with vaccination, right? I mean, in the primary series — I mean, booster takeup was low — but in the primary when there was a lot of uncertainty about the vaccines, the people who said “no way I am ever going to get the vaccine” — I mean, KFF was surveying this every month — most of them didn’t. You know, a few on the margins did, but most of them who were really militantly against the vaccine didn’t take it. The ones who were “I don’t know” and “I’m a little scared” and “I’m waiting and seeing” … a lot of them did take it. They were reached. And that’s sort of an important lesson to shift the focus as we deal with distrust, as we deal with disinformation and we deal with messaging, which is good, and truth-building and confidence-building, it is that muddled middle that’s going to have to be more of a target than we have traditionally thought.

Rovner: Well, in the interest of actually giving good information, we have a couple of updates on the reproductive health front. For those of you keeping score, abortion bans took effect this week in South Carolina and Indiana after long drawn-out court battles. Meanwhile, in Texas, an update to our continuing discussion of women with pregnancy complications who’ve been unable to get care because doctors fear running afoul of that state’s ban, a couple of weeks ago, reports Selena Simmons-Duffin at NPR, Texas Gov. Greg Abbott very quietly signed a law that created a couple of exceptions to the ban for ectopic pregnancies and premature rupture of membranes, both of which are life-threatening to the pregnant woman, but just not necessarily immediately life-threatening. I had not heard a word about this change in the law until I saw Selena’s story. Had any of you?

Kenen: In fact, it should have come up because of this court case in Texas about, you know, a broader health exception — it’s not even “health,” it’s life-threatening. It’s like, at what point do you get sick enough that your life is in danger as opposed to, you know, should you be treating that woman before … you see what direction it’s going, and you don’t let them go to the brink of death? I mean, that was the court case and Abbott fought that. But yeah, it was interesting.

Rovner: It was a really interesting story that was also, you know, pushed by a state legislator who was trying very hard not to … never to say the word abortion and to just make sure that, you know, this was about health care and not abortion. It’s an interesting story, we will link to it.

Sanger-Katz: I wonder if other states will do this as well. It seems like, as we’ve discussed, you know, abortion bans are not as popular as I think many Republican politicians thought they would [be]. And I do think that these cases of women who face really terrible health crises and are unable to get treated are contributing to the public’s dislike of these policies. And on the one hand, I think that there is a strong dislike of exceptions among people who support abortion bans because they don’t want the loopholes to get so big that the actual policy becomes meaningless. On the other hand, it seems like there is a real incentive for them in trying to fix these obvious problems, because I think it contributes to bad outcomes for women and children. And I think it also contributes to political distaste for the abortion ban itself.

Kenen: But it’s very hard to legislate every possible medical problem …  I mean, what Texas did in this case was they legislated two particular medical problems. And some states … they have the ectopic — I mean, ectopic is not … there’s no stretch of the imagination that that’s viable. Right? The only thing that happens with an ectopic pregnancy is it either disintegrates or it hemorrhages. I mean, the woman is going to have a problem, but making a list of “you get this condition, you can have a medical emergency abortion, but if you have that condition and your state legislator didn’t happen to think about it, then you can’t.” I mean, the larger issue is: How do you balance the legal restrictions and medical judgments? And that’s … I don’t think any state that has a ban has completely figured that out.

Rovner: Right. And we’re back to legislators practicing medicine, which is something that I think the public does seem to find distasteful.

Sanger-Katz: I mean, I don’t think that this solves the problem at all, but I think it does show a surprising responsiveness to the particular bad outcomes that are getting the most publicity and a sort of new flexibility among the legislators who support these abortion bans. So it’s interesting.

Rovner: All right. Meanwhile, another shocking story about pregnant women being treated badly. The Centers for Disease Control and Prevention reported this week that a survey conducted this April found that 1 in 5 women reported being mistreated by medical professionals during pregnancy or delivery. For women of color, the rate was even higher: more than 1 in 4. Mistreatment included things like getting no response to calls for help, being yelled at or scolded, and feeling coerced into accepting or rejecting certain types of treatment. We know a lot of cases where women in labor or after birth reported problems that went ignored. Among the most notable, of course, was tennis legend Serena Williams, who gave birth to her second child this week after almost not surviving the birth of her first. We’re hearing so much about the high maternal mortality rate in the U.S. What is it going to take to change this? This isn’t something that can be solved by throwing more money at it. This has got to be sort of a change in culture, doesn’t it?

Kenen: No. I mean, it’s … if someone who’s just given birth, particularly if it’s the first time and you don’t know what’s normal and what’s not and what’s dangerous and what’s not dangerous, and, you know, it’s a trauma to your body. I mean, you know, I had a very much-wanted child, but labor is tough, right? I always say that evolution should have given us a zipper. But the philosophy should be, if someone who’s just been through this physical and emotional ordeal, has discomfort or a question or a fear, that you respect it and that you calm it down, you don’t dismiss it or yell at somebody. When you’re pregnant, you read all these books and you go to Lamaze workshops and you learn all this stuff about labor and delivery. You learn nothing about what happens right after. And it’s actually quite uncomfortable. And no one had ever told me what to expect. And I didn’t know. And I always, like, when younger women are having babies, I let them know that, you know, talk to your doctor or learn about this or be prepared for this, because that is a really vulnerable point. And that this survey — and it’s more Black and poor women, and Latina women in this survey, it’s not that … it’s disproportionate like everything else in health care — they’re being disrespected and not listened to. And some of them are going to have bad medical outcomes because of that.

Rovner: As we are seeing. All right. Well, that is this week’s news now. We will take a quick break. Then we will come back and do our extra credit.

Hey, “What the Health?” listeners: You already know that few things in health care are ever simple. So if you like our show, I recommend you also listen to “Tradeoffs,” a podcast that goes even deeper into our costly, complicated, and often counterintuitive health care system. Hosted by longtime health journalist and my friend Dan Gorenstein, “Tradeoffs” digs into the evidence and research data behind health care policies and tells the stories of real people impacted by decisions made in C-suites, doctors’ offices, and even Congress. Subscribe wherever you get your podcasts.

OK, we’re back. It’s time for our extra-credit segment. That’s when we each recommend a story we read this week we think you should read too. As always, don’t worry, if you missed it; we will post the links on the podcast page at KFFHealthNews.org and in our show notes on your phone or other mobile device. Victoria, why don’t you go first this week?

Knight: So my extra credit is from The New York Times, and the story is called “The Next Frontier for Corporate Benefits: Menopause.” It basically details how a lot of companies are realizing that, you know, as more women get into leadership positions, high-level leadership, executive positions, they’re in their 40s, late 40s, early 50s, that’s when menopause or perimenopause starts happening. And that’s something that can last for a while. I didn’t realize the stories, that it can last almost 10 years sometimes. And so it was talking about how, you know, it affects women for a long period of time. It can also affect their productivity in the workplace and their comfort and being able to accomplish things. And so they were realizing, you know, we kind of need to do something to help these women stay in these positions. And there was actually an interesting tidbit at the very end where it was talking about some companies may even be, like, legally compelled to make accommodations. And that’s due to the new Pregnant Workers Fairness Act, which says that employers have to provide accommodations for people experiencing pregnancy but also related medical conditions. They’re saying menopause could be included in that. And just some of the benefits some of these companies were offering were access to virtual specialists, but they were talking about, like, if they need to do other things like cooling rooms and stuff like that. So I thought it was kind of interesting. And another employer benefit that maybe some employers are thinking about adding.

Kenen: I think all offices should have, like, little nap cubicles and man-woman, pregnant-not pregnant. And, you know, just like “life is rough.” [laughter]

Knight: I agree.

Kenen: Just a little corner!

Rovner: Joanne, why don’t you go next?

Kenen: Mine is from The Atlantic. It’s by Lola Butcher. And it is “A Simple Marketing Technique Could Make America Healthier.” And it’s basically talking about how some medical practices are doing what we in the news business and the tech industry knows of as “A-B testing.” You know, a tech company may try a big button or a little button and see which one consumers like. Newsrooms change headlines— headline A, headline B and see which one draws more readers — and that hospitals and medical practices have been trying to do. In some cases, it’s text messaging two different kinds of reminders to figure out, you know … one example was the message with something like 78 characters got women to book a mammogram, but a message with 155 characters did not. Two text messages were better than one for booking children’s vaccines. So some people are very excited about this. It’s getting people to do preventive care and routine care. And some people think this is just not the problem with health care, that it’s way deeper and more systemic and that this isn’t really going to move the needle. But it was an interesting piece.

Rovner: Any little thing helps.

Kenen: Right. This was an interesting piece.

Rovner: Margot.

Sanger-Katz: I wanted to talk about an article in KFF Health News from Taylor Sisk. The headline is “Life in a Rural ‘Ambulance Desert’ Means Sometimes Help Isn’t on the Way,” and it’s a really interesting exploration of some of the challenges of ambulance care in rural areas, which is a topic that is near and dear to my heart. Because when I was a reporter in New Hampshire covering rural health care delivery, I spent the better part of a year writing about ambulance services and the challenges there. And I think this story is highlighting a real challenge for people in these communities. And I think it’s also really a reminder that the ambulance system is this weird, off-to-the-side part of our health care system that I think is often not well integrated and not well thought of. It tends to be regulated as transportation, not as health care. It tends to be provided by local governments or by contractors hired by local governments as opposed to health care institutions. It tends to have a lot of difficulty with billing a very high degree of surprise billing for its patients, and also just a real lack of health services research about best practices for how fast ambulances should arrive, what level of care they should provide to people, and on and on. And I just think that it’s good that she’s highlighted this issue. And also, I think it is a reminder to me that ambulances are probably worth a little bit more attention from reporters overall.

Rovner: Well, my story is also something that’s near and dear to my heart because I’ve been covering it for a long time. It’s from my KFF Health News colleague Lauren Sausser. It’s called “Doctors and Patients Try to Shame Insurers Online to Reverse Prior Authorization Denials.” And it is a wonderful 2023 update to a fight that Joanne and I have been covering since, what, the late 1990s. It even includes comments from Dr. Linda Peeno, who testified about inappropriate insurance company care denials to Congress in 1996. I was actually at that hearing. The twist, of course, now is that while people who were wrongly denied care at the turn of the century needed to catch the attention of a journalist or picket in front of the insurance company’s headquarters. Today, an outrage post on Instagram or TikTok or X can often get things turned around much faster. On the other hand, it’s depressing that after more than a quarter of a century, patients are still being caught in the middle of appropriateness fights between doctors and insurance companies. Maybe prior authorization will be the next surprise medical bill fight in Congress. We shall see. All right. That is our show for the week. As always, if you enjoy the podcast, you can subscribe wherever you get your podcasts. We’d appreciate it if you left us a review; that helps other people find us, too. Special thanks, as always, to our amazing engineer, Francis Ying. Also, as always, you can email us your comments or questions. We’re at whatthehealth@kff.org. Or you can tweet me or X me or whatever. I’m @jrovner, also on Bluesky and Threads. Joanne?

Kenen: I am also on Twitter, @JoanneKenen; and I’m on Threads, @joannekenen1; and Bluesky, JoanneKenen.

Rovner: Margot.

Sanger-Katz: I’m @sangerkatz.

Rovner: Victoria.

Knight: I’m @victoriaregisk on X and Threads.

Rovner: Well, we’re going to take a week off from the news next week, but watch your feed for a special episode. We will be back with our panel after Labor Day. Until then, be healthy.

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1 year 7 months ago

Courts, COVID-19, Elections, Medicaid, Multimedia, States, The Health Law, Abortion, KFF, KFF Health News' 'What The Health?', Misinformation, Podcasts, Polls, Pregnancy, texas, Women's Health

Health | NOW Grenada

The UWI leads regional dialogue on climate change and mental health

According to Ambassador Bristol, “Climate change and mental health are recognised as two of the greatest global challenges the region faces”

1 year 7 months ago

Business, Environment, Health, climate change on mental health, gillian bristol, lacc, latin american-caribbean centre, the university of the west indies, the uwi

PAHO/WHO | Pan American Health Organization

Update on variant of interest EG.5 and variant under surveillance BA.2.86

Update on variant of interest EG.5 and variant under surveillance BA.2.86

Cristina Mitchell

23 Aug 2023

Update on variant of interest EG.5 and variant under surveillance BA.2.86

Cristina Mitchell

23 Aug 2023

1 year 7 months ago

Health

How to take care of your skin

VITAMINS AND minerals play a crucial role in maintaining the health and appearance of the skin. They contribute to various skin functions, including cell regeneration, collagen production, protection against environmental damage, and overall skin...

VITAMINS AND minerals play a crucial role in maintaining the health and appearance of the skin. They contribute to various skin functions, including cell regeneration, collagen production, protection against environmental damage, and overall skin...

1 year 8 months ago

Health

For your perfect skin

BOOSTING THE quality of your diet checks a lot of boxes for your health. Weight, energy, and proper nutrition come to mind first. The health of your skin should be added to that list as nutritional skincare illuminates the natural radiance of your...

BOOSTING THE quality of your diet checks a lot of boxes for your health. Weight, energy, and proper nutrition come to mind first. The health of your skin should be added to that list as nutritional skincare illuminates the natural radiance of your...

1 year 8 months ago

Healio News

COVID-19 lockdowns may have caused myopic shift in children

Mandatory online schooling and confinement during the COVID-19 pandemic may have exacerbated myopia in school-aged children in Puerto Rico, according to a review published in Optometry and Vision Science.“Online learning increased students’ time on electronics indoors and reduced their time outside during the COVID-19 pandemic quarantine,” study author Neisha M.

Rodriguez, OD, PhD, MPH, associate professor at Inter American University of Puerto Rico School of Optometry, and colleagues wrote. “The previously mentioned factors are believed to increase a child’s

1 year 8 months ago

Health – Demerara Waves Online News- Guyana

Mahdia dorm fire victim discharged from New York’s Staten Island hospital 3 months after fatal blaze

STATEN ISLAND, New York City (WABC) — It’s been three long months of surgeries, skin grafts, physical rehabilitation, and grief counseling. But Monday, three months to the day of a fatal fire that claimed the lives of 20 students in a girl’s dormitory in Guyana, the most critically burned patient will be discharged. Mariza Williams was ...

STATEN ISLAND, New York City (WABC) — It’s been three long months of surgeries, skin grafts, physical rehabilitation, and grief counseling. But Monday, three months to the day of a fatal fire that claimed the lives of 20 students in a girl’s dormitory in Guyana, the most critically burned patient will be discharged. Mariza Williams was ...

1 year 8 months ago

Health, News

Health – Dominican Today

Public Health activated the Contingency Plan for the threat of Tropical Storm Franklin

Santo Domingo.- The Ministry of Public Health (MSP) has taken proactive steps by activating its National Contingency Plan to mitigate the potential impact of tropical storm Franklin, anticipated for Tuesday, August 22, as forecasted by the National Meteorological Office (ONAMET).

Santo Domingo.- The Ministry of Public Health (MSP) has taken proactive steps by activating its National Contingency Plan to mitigate the potential impact of tropical storm Franklin, anticipated for Tuesday, August 22, as forecasted by the National Meteorological Office (ONAMET).

Leading a coordination meeting with vice ministers and directors of the institution, Minister of Health, Dr. Daniel Rivera, instructed the Rapid Response Teams to initiate actions in line with the “Assessment of Damages and Analysis of Health Needs in Emergency Situations (EDAN-Salud).” This collaboration takes place in coordination with the Emergency Operations Center (COE).

Dr. Rivera emphasized the paramount importance of safeguarding the public’s health. He urged all personnel to be ready to respond to any emerging emergency situations arising from the impending weather phenomenon, as indicated by meteorological predictions. Preventing disease transmission is crucial, as episodes such as diarrhea, dengue fever, malaria, and other ailments tend to escalate during hurricane season and heavy rainfall periods. The implementation of effective health measures can mitigate the potential consequences.

Dr. Gina Estrella, Director of Risk Management and Disaster Care, noted that the Ministry of Health has been in a continuous session due to the looming threat of the storm. This state of readiness extends to both headquarters and Provincial Directorates and Health Areas. Dr. Estrella called upon local authorities to take appropriate actions to ensure the well-being and safety of residents in their jurisdictions. Special attention is given to provinces under alert, particularly Pedernales and Dajabón, where the storm’s impact is expected to be most pronounced.

Assured provision of medicines, supplies, and necessary resources is a priority for the Ministry to effectively assist those in need during the crisis.

Key actions include:

– Activation of the COE-Health in a continuous session.
– Ongoing monitoring from the Situation Room of the Directorate of Risk Management and Disaster Assistance.
– Activation of Provincial Health Committees, integration of Provincial and Municipal COEs, and response plan activation for hospitals in respective jurisdictions.
– Evaluation of temporary shelters identified by Civil Defense for authorization.
– Inventory of available resources for response needs.
– Activation of local rapid response teams.

The Ministry of Health underscores the importance of preventive measures during the rainy season. In particular, increased occurrences of acute respiratory diseases, epidemics, and the potential spread of diseases like dengue, leptospirosis, acute diarrheal disease, Covid-19, and others. Precautionary steps include practicing permanent hand washing, ensuring the safety of drinking water, maintaining hygienic practices for food and utensils, using tissues when sneezing, protecting vulnerable groups, and being equipped with necessary medications.

The Emergency Operations Center has placed the entire country under alert. The southern coast is on red alert, the central region and extreme east are on yellow alert, and the north and northeast coasts are on green alert. The forecast anticipates heavy rainfall across the nation due to the direct impact of the storm.

1 year 8 months ago

Health

Healio News

Epcoritamab plus R-CHOP achieve high response rates in untreated high-risk DLBCL

CHICAGO — Epcoritamab plus R-CHOP induced high complete metabolic response rates in previously untreated high-risk diffuse large B-cell lymphoma and double-hit or triple-hit lymphoma, according to research presented at ASCO Annual Meeting.The study, presented by Lorenzo Falchi, MD, evaluated 46 patients with previously untreated high-risk DLBCL , 11 of whom had double-hit or triple-hit lymphoma

. Patients received 48 mg epcoritamab (DuoBody-CD3xCD20; Genmab, AbbVie) plus R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone).Of these patients, 100% had a response

1 year 8 months ago

Health – Dominican Today

Government initiates purchase of Maharishi’s land; a hospital would be built

Santo Domingo.- Elías Matos, a deputy representing Constituency One of the National District for the Modern Revolutionary Party (PRM), highlighted on Monday that the Dominican Government has initiated the process of acquiring the land previously occupied by the Maharishi school.

Santo Domingo.- Elías Matos, a deputy representing Constituency One of the National District for the Modern Revolutionary Party (PRM), highlighted on Monday that the Dominican Government has initiated the process of acquiring the land previously occupied by the Maharishi school. This land is being considered for the construction of a much-needed major hospital, especially in the southern region of the capital.

Matos specified that he has been advocating for the establishment of a large hospital to serve the sectors in the southern part of Constituency One and the entire National District since September 2020.

“We have received information that the Dominican Government has begun the necessary steps to acquire the land of the old Maharishi College,” stated the legislator. He also mentioned that the premises encompass an area of over 50,000 square meters, which could be repurposed for this purpose.

The legislator, who aligns with the ruling party, emphasized his commitment to the concept of creating a comprehensive hospital in Constituency One. He envisioned a hospital with specialized units such as geriatrics, pediatrics, traumatology, and a burn unit, among other healthcare specialties.

Matos expressed confidence that the Dominican Government will heed the voices of the citizens who are eager for a high-quality and accessible healthcare service. He noted that the hospital’s strategic location would help alleviate congestion in other healthcare centers and expedite assistance from the National Emergency and Security System 9-1-1.

Elías Matos acknowledged President Luis Abinader’s responsiveness to the needs of the people and expressed optimism that an official announcement regarding the construction of the major hospital in the southern part of the National District will be forthcoming in the upcoming days.

It is worth noting that on September 18, 2020, Deputy Elías Matos, representing Constituency One of the National District for the Modern Revolutionary Party, submitted a draft resolution through the General Legislative Secretariat of the Chamber of Deputies. In the resolution, he urged President Luis Abinader to consider the construction of a general hospital in the Miramar sector, located at kilometer 8 of Independencia Avenue.

In his address, the deputy highlighted that the population in the sectors of the National District exceeds 315,000 people, with a population density approaching 8,000 inhabitants per square kilometer. He emphasized the need for a general hospital in this area to alleviate pressure on other healthcare centers in the city, particularly within the coastal strip between the 30 de Mayo highway and the Sánchez highway, which accommodates around 200,000 residents.

1 year 8 months ago

Health

Medical News, Health News Latest, Medical News Today - Medical Dialogues |

Blue-light filtering spectacles may make no difference to eye strain, eye health or sleep quality

Spectacles that are marketed to filter out blue light probably make no difference to eye strain caused by computer use or to sleep quality, according to a review of 17 randomised controlled trials of the best available evidence so far.

Nor did the review find any evidence that blue-light filtering lenses protect against damage to the retina, the light-sensitive tissue at the back of the eye, as included studies did not evaluate this outcome. Blue-light filtering lenses, also known as blue-light blocking spectacles, have been increasingly prescribed or recommended, often by optometrists, since the early 2000s.

The new review, published in the Cochrane Database of Systematic Reviews, was led by researchers at the University of Melbourne in collaboration with colleagues at City, University of London and Monash University.

The team set out to assess the effects of blue-light filtering lenses compared with non-blue-light filtering lenses for improving visual performance, providing protection to the retina and improving sleep quality. They analysed data from all the randomised controlled trials they could find on the topic and found 17 trials from six countries. The numbers of participants in individual studies ranged from five to 156, and the period of time over which the lenses were assessed ranged from less than one day to five weeks.

The senior author of the review is Associate Professor Laura Downie, Dame Kate Campbell Fellow and Head of the Downie Laboratory: Anterior Eye, Clinical Trials and Research Translation Unit, at the University of Melbourne, Victoria, Australia.

She said: “We found there may be no short-term advantages with using blue-light filtering spectacle lenses to reduce visual fatigue associated with computer use, compared to non-blue-light filtering lenses. It is also currently unclear whether these lenses affect vision quality or sleep-related outcomes, and no conclusions could be drawn about any potential effects on retinal health in the longer term. People should be aware of these findings when deciding whether to purchase these spectacles.”

However, the quality and duration of the studies also needs to be considered, she said.

“We performed the systematic review to Cochrane methodological standards to ensure the findings are robust. However, our certainty in the reported findings should be interpreted in the context of the quality of the available evidence. The short follow-up period also affected our ability to consider potential longer-term outcomes.”

The first author of the review, Dr Sumeer Singh, a postdoctoral research fellow in the Downie Laboratory, said: “High-quality, large clinical research studies with longer follow-up in more diverse populations are still required to ascertain more clearly the potential effects of blue-light filtering spectacle lenses on visual performance, sleep and eye health. They should examine whether efficacy and safety outcomes vary between different groups of people and using different types of lenses.”

The review did not find any consistent reports of adverse side effects from using blue-light filtering lenses. Any effects tended to be mild, infrequent and temporary. They included discomfort wearing the spectacles, headaches and lower mood. These were likely to be related to the wearing of spectacles generally, as similar effects were reported with non-blue-light filtering lenses.

Prof. Downie said: “Over the past few years, there has been substantial debate about whether blue-light filtering spectacle lenses have merit in ophthalmic practice. Research has shown that these lenses are frequently prescribed to patients in many parts of the world, and a range of marketing claims exist about their potential benefits, including that they may reduce eye strain associated with digital device use, improve sleep quality and protect the retina from light-induced damage. The outcomes of our review, based on the current, best available evidence, show that the evidence is inconclusive and uncertain for these claims. Our findings do not support the prescription of blue-light filtering lenses to the general population. These results are relevant to a broad range of stakeholders, including eye care professionals, patients, researchers and the broader community.”

The potential mechanisms by which blue-light filtering lenses might be able to help with eye strain, sleep and protecting the retina are unclear. One basis for claims about the benefits of these lenses is that modern digital devices such as computers and smart phones emit more blue light than traditional lighting sources, and are being used for longer, and closer to bedtime.

Dr Singh said: “The amount of blue light our eyes receive from artificial sources, such as computer screens, is about a thousandth of what we get from natural daylight. It’s also worth bearing in mind that blue-light filtering lenses typically filter out about 10-25% of blue light, depending on the specific product. Filtering out higher levels of blue light would require the lenses to have an obvious amber tint, which would have a substantial effect on colour perception.”

Reference:

Downie LE, Keller PR, Busija L, Lawrenson JG, Hull CC. Blue‐light filtering spectacle lenses for visual performance, sleep, and macular health in adults. Cochrane Database Syst Rev. 2019 Jan 16;2019(1):CD013244. doi: 10.1002/14651858.CD013244. 

1 year 8 months ago

Ophthalmology,Ophthalmology News,Latest Medical News

Health – Dominican Today

ADTS announces investment of more than 12 billion pesos in medical tourism

The directors of the Dominican Association of Health Tourism (ADTS), Alejandro Cambiaso, president, and Amelia Reyes Mora, vice-president of the organization and president of AF Comunicación Estratégica, announced an investment of over 12 billion pesos in the medical tourism sector.

They stated that during the 6th International Congress on Health Tourism, a private investment breakfast will be held in conjunction with the financial sector. New ventures in this booming niche market will be presented, providing the country with thousands of jobs and innovative medical technologies and services.

Cambiaso said that the congress will be held on November 1 and 2 of this year at the JW Marriott Hotel in Santo Domingo and will feature multiple innovations and business opportunities, highlighting, above all, the talent of the Dominican medical class and its achievements, according to the program Esta Noche Mariasela.

Amelia Reyes Mora said the event will be a meeting point for multi-sector leaders. The country will be projected as a health and investment destination, promoting international accreditations and the projection of Dominican medicine.

It is noted that the DR is the leading destination for medical tourism in the Caribbean, number 2 in Latin America, and number 19 in the world, according to the Medical Tourism Index.

1 year 8 months ago

Health, tourism

Health Archives - Barbados Today

Region urged to prevent trans-border spread of infectious diseases

(CMC) – The Trinidad-based Caribbean Public Health Agency (CARPHA) says regional countries need to take adequate steps to prevent the trans-boundary spread of infectious diseases, describing it as a threat to regional and global health security.

CARPHA held a two-day conference in Trinidad and Tobago last week to discuss the devastating impact of the COVID-19 pandemic and other public health concerns, reiterating the necessity for regional and global health security to protect and improve health.

It said that Regional Health Security (RHS) encompasses the capacities required for the Caribbean to prepare for and respond to public health threats, risks, priority issues and concerns that transcend national boundaries and potentially impact on economic stability, trade, tourism, and access to goods and services in the region.

“RHS offers a coordinated approach which is especially crucial in the Caribbean as the region, like the Pacific and African small island developing states, is characterised by small, under-resourced populations and varying surveillance, laboratory and human resource capacities,” CARPHA said.

“It is also highly interconnected with porous borders, heavily reliant on tourism, and susceptible to climate change and disasters.”

The agency noted that this combination of factors significantly increases the region’s exposure and vulnerability to disease spread, enabling rapid spread of highly transmissible communicable diseases.

Furthermore, the tropical climate, and abundance of competent vectors make the region particularly vulnerable to vector-borne disease outbreaks.

“Consequently, regional health security and prevention, preparedness and response to public health emergencies need to be improved not only at the national levels, but at the regional level, as functional regional capacities are greater than the sum of the capacities of individual countries for improving RHS in the Caribbean,” CARPHA said.

“The major outcomes of this meeting include the detailing and prioritisation of member states’ current needs, increased awareness of CARPHA’s integrated surveillance and capacity building work and strengthening partnerships. These elements will assist in developing the sustainable RHS Pathway in short order.”

The post Region urged to prevent trans-border spread of infectious diseases appeared first on Barbados Today.

1 year 8 months ago

A Slider, Health, Regional

Jamaica Observer

When seconds count... count on CPR

Efficient
pre-hospital care plays a critical role in saving the lives of people experiencing medical emergencies.

Efficient
pre-hospital care plays a critical role in saving the lives of people experiencing medical emergencies.

In cardiac and respiratory emergencies, the focus is on performing early cardiopulmonary resuscitation (CPR), defibrillation, in field diagnostics (ECG telemetry), initiation of treatment (aspirin, nitrates) as per protocol, and rapid transport to hospitals with capabilities of treating with cardiac emergencies.

The above-mentioned are the ideal scenarios, but in resource-challenged environments such as ours, these ideals remain only aspirational.

The chain of survival is a conceptual framework in the Emergency Cardiac Care community that outlines a series of six vital steps that are necessary to maximise a person's chances of survival during cardiac arrest.

Let us assess the readiness of Jamaica to provide the chain of survival for victims of cardiac arrest.

Link 1. Activation of the emergency response

Early recognition and activation of the prehospital emergency response is the first link in the chain of survival. Currently there is limited public awareness about recognising cardiac arrest symptoms. As a result, delays in seeking medical help are very common, thus hampering the effectiveness of this link.

Link 2. High-quality CPR

The immediate initiation of bystander CPR is essential for the success of any emergency medical response for cardiac arrest. In Jamaica, bystander CPR rates are dismally low due to limited knowledge and training among the general population. Reluctance to perform CPR may also be influenced by cultural factors and the fear of doing harm.

Over the past two decades the Heart Foundation of Jamaica has been an advocate for layperson CPR training as well as providing training for both prehospital and in-hospital medical responders. However, greater efforts are required to educate citizens about performing CPR, and to dispel the fears of people who may be willing to learn.

Link 3. Early defibrillation

This link speaks to the early use of automated external defibrillators (AEDs) on patients who are in cardiac arrest. It is used to deliver a "shock' to the patient. This is the only treatment for patients who are in cardiac arrest due to the lethal cardiac rhythms of ventricular fibrillation or ventricular tachycardia.

The availability of AEDs in public spaces is very limited. This may be due to two factors — cost and absence of legislation. The need for public access defibrillation is a cornerstone of the thrust to strengthen the chain of survival.

Link 4. Early advanced care

Prehospital Emergency Medical Care in Jamaica currently has two operational systems. There is a formal Ministry of Health and Wellness (MOHW)/Ministry of Local Government and Community Development (MLG & CD) emergency medical service. This service is manned by emergency medical technicians (EMTs), from the fire brigade-trained to the basic EMT level. This emergency medical service (EMS) operates in the parishes of Westmoreland, St James, Trelawny, and St Catherine.

The other system is that of private EMS operators. These private services operate in all parishes and provide a greatly needed service, although, operationally, they are largely unregulated. Great strides have been made over the years in training emergency room staff in basic and advanced life support, but there are still resource issues in our emergency rooms, which mitigate against offering patients the full level of care that is routinely available in places with more resources.

Link 5. Integrated post-cardiac arrest care

All patients who have achieved return of spontaneous circulation (ROSC) require admission to an intensive care unit (ICU). This high level of care is required because the underlying cause of the cardiac arrest often still exists, and the patient is at great risk of going back into cardiac arrest. The Jamaican reality is that there are simply not enough ICU beds available for the population.

Link 6. Recovery

The sixth link is recovery. It focuses on the need for continued treatment and rehabilitation of cardiac arrest survivors. It also focuses on the families and caregivers of the survivors.

Critical concepts for recovery include:

• Comprehensive post-cardiac arrest discharge planning for survivors and their families and caregivers. This includes medical follow-up and rehabilitative treatment. Advice on return to activity and work and management of these expectations.

• Assessment and treatment of the cardiopulmonary, neurologic, and cognitive impairments that often affect cardiac arrest survivors.

• Assessment and treatment of the many psychiatric ailments which beset near-death experiences. These include anxiety, depression, post-traumatic stress, and chronic fatigue.

Unfortunately, there is little or no focus on this very important sixth link.

Recommendations

To enhance Jamaica's readiness in providing the chain of survival, the following strategies are suggested.

1. Initiate State-funded public education programmes about recognising the symptoms of cardiac arrest and the steps in performing CPR

2. Create cardiac-ready communities. This involves the establishment of communities that meet the criteria for having:

*Laypersons trained in CPR. Free CPR training to communities empowers the citizens to provide immediate help in emergencies.

*Public access to AEDs. Increasing the availability and deployment of AEDs in public spaces, workplaces, and transportation centres can decrease the time to defibrillation.

*Blood pressure, cholesterol, and diabetic screenings. Identifies groups at higher risk of cardiac arrest. Allows for intervention.

*A functional EMS. Ensures timely and effective prehospital care and transport.

*Investment in road infrastructure. Improving road networks and addressing traffic congestion can facilitate faster EMS response.

*A properly equipped and staffed emergency room in the local hospital.

While Jamaica has invested in its health-care professionals with an emphasis on training and the existence of public and private EMS, there are significant challenges that impede its readiness to provide all the links in the chain of survival. A chain is as strong as its weakest link; therefore, the thrust must be to strengthen all the links.

By addressing the recognised issues of public awareness, CPR training, AED availability, and resource allocation, Jamaica can strengthen its pre-hospital, in-hospital, and post-hospital care, and contribute to a more robust chain of survival.

CPR week is being observed in Jamaica from August 21-24.

Dr Hugh Wong DM (Emergency Medicine) is the director of emergency cardiac care at the Heart Foundation of Jamaica. He can be contacted at hmarkwong@gmail.com

1 year 8 months ago

Jamaica Observer

Foamy urine: What does it mean?

REGARDING bathroom habits, you likely don't pay much attention when everything goes smoothly. You might already be aware of some inconsequential changes, such as dark-yellow urine indicating dehydration, or the unpleasant odour that comes from consuming certain foods like asparagus. However, foamy urine might be a less familiar concept.

Foamy urine often suggests the presence of protein in the urine, which can be indicative of kidney issues. Your kidneys are responsible for filtering and retaining protein in your body, so if they're not functioning properly it can lead to protein leakage. Health conditions affecting the kidneys or other bodily systems like diabetes could also result in foamy urine.

Should your urine appear foamy consistently over several days and you experience additional symptoms like leg or eye swelling, consulting a doctor is advisable. Here are five potential reasons for foamy urine and corresponding actions to take if the issue occurs:

1. Urine stream: A certain degree of bubbles in urine is typical and can be influenced by the speed of urination and the distance the urine travels before reaching the toilet.

2. Dehydration: Urine contains water so inadequate fluid intake can lead to foamy urine. Greater dehydration leads to more concentrated urine, resulting in foaminess due to the higher concentration of substances in a smaller water volume. If you observe foamy urine, a useful initial step is to increase hydration. Consuming beverages with electrolytes can aid in hydration and maintaining salt levels, which often decrease when dehydrated. Severe dehydration can prompt muscle pain, dizziness, confusion, and breathing difficulties. Immediate medical attention is necessary if such symptoms occur.

3. Kidney disease: Normally the kidneys' filters prevent protein molecules from entering the urine. An increase in protein in urine typically signifies damaged filter functions. Foamy urine might be one sign of kidney damage, accompanied by symptoms like fluid retention-related swelling or weight gain. Consulting a doctor is recommended if these symptoms are present. A basic urine test by a primary care provider can reveal protein presence and quantity. Based on the results and medical history a nephrologist may be consulted for further blood tests to identify the cause and prescribe treatment.

4. Diabetes or hypertension: Once more, protein in urine plays a role. Both diabetes, (affecting insulin levels), and hypertension, (or high blood pressure), can impair kidney blood flow and function. Elevated pressure causes stress, leading to kidney damage and protein leakage, resulting in foaminess. Both conditions have other symptoms too — diabetes may cause increased urination and thirst while hypertension might manifest as chest pain or breathlessness. If these symptoms coincide with foamy urine, informing your doctor is advised. Management often involves oral medications and adopting a healthy lifestyle inclusive of exercise; a balanced diet low in sugar, calories, and salt; and moderate alcohol intake.

When to be concerned about foamy urine

If foamy urine occurs only once there's no immediate cause for concern. But if foamy urine becomes a regular occurrence or persists for days to a week, consulting a doctor is advisable. Pregnant individuals should be particularly cautious as protein in the urine could indicate pre-eclampsia — a serious condition. In such cases, promptly informing your doctor is essential.

Dr Jeremy Thomas is a consultant urologist. He works privately in Montego Bay, Savanna-la-Mar and Kingston, and publicly at Cornwall Regional Hospital. He may be contacted on Facebook and Instagram: @jthomasurology or by e-mail: jthomasurology@gmail.com

1 year 8 months ago

Jamaica Observer

The Americas seek to expand genomic surveillance for dengue, chikungunya, and other mosquito-borne viruses

PAHO, SANTO DOMINGO — Laboratory experts gathered recently in Santo Domingo, Dominican Republic, to discuss increasing the use of tools to detect and monitor mosquito-borne diseases in the Americas.

The meeting, led by the Pan American Health Organization (PAHO), comes as some countries in the region face large-scale outbreaks of dengue and intense circulation of chikungunya.

Members, which are made up of 35 national laboratories from across the region, technical advisors, and World Health Organisation (WHO) collaborating centres, will review ways to expand genomic and entomovirological surveillance to major arboviruses.

"At least nine arboviruses with public health impact — such as dengue, zika, chikungunya, and yellow fever — are circulating in Latin America and the Caribbean, so strengthening and expanding laboratory detection and surveillance capacities are key to ensuring a timely response to outbreaks and epidemics," Sylvain Aldighieri, deputy director of PAHO's Department of Health Emergencies, said.

Arboviruses are transmitted by the bite of arthropods (mosquitoes and ticks, among others). From the beginning of 2023 until the end of July, more than 3 million new dengue infections and more than 324,000 cases of chikungunya were reported in the Americas. With 27,000 cases across the region in the same period, Zika has a lower incidence rate, while sporadic cases of yellow fever represent a permanent risk of re-emergence of this potentially lethal disease.

"The epidemiological picture of arboviruses in the region is highly complex due to the epidemic potential of these diseases," José Luis San Martín, PAHO regional advisor on arboviral diseases, warned. "We must carry out an integrated prevention and control strategy that uses new innovations to closely monitor these viruses in laboratories," he added.

During the COVID-19 pandemic, genomic surveillance of SARS-CoV-2 proved key to understanding the virus, its variants, and advising public policy to prevent and control of the disease.

In the past years, investment and international cooperation have strengthened Arbovirus Diagnosis Laboratory Network of the Americas (RELDA) laboratories, and now at least eight countries in the region have introduced genomic sequencing within the framework of PAHO's Regional Strategy for Genomic Surveillance.

Many countries are taking advantage of these capacities and have started sequencing dengue, yellow fever, chikungunya, and other viruses, some for the first time. With RELDA's support, laboratories can expand this surveillance to find out the genomes of arboviruses circulating in their territory, their dispersion patterns, and analyse whether mutations are associated with greater transmissibility or severity.

For María Alejandra Morales, director of the PAHO/WHO Collaborating Centre on Viral Haemorrhagic Fevers and Arboviruses, National Institute of Human Viral Diseases (INEVH) in Argentina, "RELDA has a key role to play in the strengthening, growth, and continuous improvement of the laboratory component as part of an integrated management strategy for arboviruses."

Morales, who is currently the RELDA coordinator, also believes the expanded work of the laboratories with virological, serological, and molecular tests "will make it possible to generate timely and quality information for decision-making that can contribute to the prevention and control of arboviruses".

During the meeting, experts also discussed the status of entomovirological surveillance in the region, that is, the detection of viruses in mosquitoes before they reach humans. This type of surveillance, already conducted in some countries, can serve as an early warning system to anticipate arbovirus outbreaks or epidemics and allow for a more timely response.

PAHO began promoting entomovirological surveillance in 2017 and created the Entomo-Virological Laboratory Network (RELEVA), which currently includes laboratories in 14 countries. At the meeting, guidelines for this surveillance were presented and discussed. Laboratories in the network are also working on a plan for their implementation and plan to create a comprehensive arbovirus surveillance platform that includes mosquito surveillance data.

RELDA, which celebrates its 15th anniversary this year, is composed of 40 laboratories, technical advisors, and WHO collaborating centres, and is the operational arm of the laboratory component of PAHO's Integrated Management Strategy for Arboviral Disease Prevention and Control (known as IMS-arbovirus). Its main objective is to ensure efficient laboratory surveillance and a robust installed capacity to respond to arbovirus outbreaks and epidemics.

1 year 8 months ago

Medical News, Health News Latest, Medical News Today - Medical Dialogues |

171 SR Post Vacancies: Apply Now At RML Hospital Delhi, View All Details Here

New Delhi: The Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital (ABVIMS and RML Hospital Delhi), has announced the vacancies for the post of Senior Resident (Non-Academic) on a regular basis in this medical institute.

Dr Ram Manohar Lohia Hospital, formerly known as Willingdon Hospital, was established by the British for their staff and had only 54 beds. After independence, its control was shifted to New Delhi Municipal Committee. In 1954, its control was again transferred to the Central Government of Independent India.

RML Hospital Vacancy Details:

Total no of vacancies: 171

The Vacancies are in the department of Biochemistry, Transfusion medicine(Blood Bank), Cardiac Anesthesia, ENT, Endocrinology, Forensic Medicine, Gastroenterology, Obstetrics & Gynaecology, Medicine, Microbiology, Neonatology, Ophthalmology, Orthopedics, Pediatrics, Pathology, Physical Medicine and Rehabilitation, Psychiatry, Radiology, Dermatology, Surgery, Anesthesia, Anatomy, Community Medicine, Respiratory Medicine, Physiology, and Pharmacology.

The last date and time of submission of the application is 25th August 2023 till 3:00 PM.

For more details about Qualifications, Age, Pay Allowance, and much more, click on the given link:

https://medicaljob.in/jobs.php?post_type=&job_tags=RML+Hospital&location=&job_sector=all

Eligible Candidates (How to Apply)?

1. The application should be submitted in the Central Diary & Dispatch Section, Near Gate No. 3, ABVIMS & Dr. Ram Manohar Lohia Hospitals New Delhi-110001, by 25.08.2023 till 03:00 PM.

2. The application should be accompanied by the latest passport-size photograph, copy of the fee receipt, and self-attested copes of all documents that should be delivered/received, either through Post or by Hand, in the name of the Director & Medical Superintendent.

3. The application sent by Post must be written prominently on the top of the envelope "Application for the Post of Senior Resident (Non-Academic) department. The Hospital will not be responsible for any Postal delay.

4. The candidates must submit a copy of the following documents (self-attested) along with the application form.

5. They should bring the original certificates at the time of the interview:

i. Certificate in support of age (10th class passing certificate).

ii. Mark Sheets of MBBS/BDS (All years).

iii. MBBS/BDS Attempt Certificate.

iv. Internship completion certificate.

v. MBBS/BDS Degree.

vi. PG Attempt Certificate.

vii. P.G. Degree/Diploma/Provisional Pass Certificate from University.

viii. DMC/DDC Registration certificate for PG/DNB/Diploma as prescribed in clause 2 a

ix. Caste/Community/Disability/EWS Certificate wherever applicable.

x. OBC Certificate only as per Annexure-II with required validity as mentioned at para 5 (b) above.

xi. NOC from present employer (if employed).

xii. Adhaar and PAN card.

xiii. Copy of fee receipt.

6. The candidates must submit the application in the prescribed form (Annexure I) and paste a recent passport-size photograph. All the documents must be self-attested including his/her photograph on the application form.

Also Read:Assistant Professor Post Vacancies At AIIMS Bhopal: View All Details Here

1 year 8 months ago

Jobs,State News,News,Health news,Delhi,Medical Jobs,Hospital & Diagnostics,Doctor News,Latest Health News,Recent Health News

Health | NOW Grenada

Minister actions on housing conditions in Mangrove, Carriacou

“The Minister, after assessing the housing conditions, said it’s unbelievable that citizens have been living in such conditions for years, with no proper help”

1 year 8 months ago

Carriacou & Petite Martinique, Community, Environment, Health, PRESS RELEASE, carriacou, Javan Williams, mangrove, ministry of carriacou and petite martinique affairs, tevin andrews

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