PAHO/WHO | Pan American Health Organization

Equitable access key to ensuring health resilience in small island developing states

Equitable access key to ensuring health resilience in small island developing states

Cristina Mitchell

31 May 2024

Equitable access key to ensuring health resilience in small island developing states

Cristina Mitchell

31 May 2024

10 months 3 weeks ago

Healio News

Top in allergy/asthma: Updates from the American Thoracic Society International Conference

A presenter at the American Thoracic Society International Conference reported that exposure to violence was associated with neutrophilic asthma among children and adolescents in Puerto Rico.The association may be due to direct effects, such as increased inflammatory markers, and indirect effects like poor diet from stress eating and depression or anxiety, Kristina M.

Gaietto, MD, MPH, a clinical instructor and postdoctoral scholar in the division of pulmonology and department of pediatrics at the University of Pittsburgh School of Medicine and UPMC Children’s Hospital of Pittsburgh,

10 months 3 weeks ago

News Archives - Healthy Caribbean Coalition

Did You Know The Tobacco Industry Has A Hold On Our Youth?

The World Health Organization (WHO) and its global partners recognize May 31 annually as World No Tobacco Day. The significance of this special day is to encourage people who smoke to quit and those who don’t to never start.

The World Health Organization (WHO) and its global partners recognize May 31 annually as World No Tobacco Day. The significance of this special day is to encourage people who smoke to quit and those who don’t to never start. World No Tobacco Day is often celebrated by highlighting the health risks associated with tobacco use and advocating for the effective monitoring of the sale, distribution, consumption and promotion of tobacco products. Every year tobacco kills more than 8 million people, 7 million of which are due to tobacco use while approximately 1.2 million are due to non-smokers being exposed to second-hand smoke.

This year’s theme for World No Tobacco Day, “Protecting children from tobacco industry interference”, cuts to the core of a disturbing truth – The tobacco industry needs replacement users and youth are a primary target. Many of us use social media and are constantly bombarded with advertisements. Disturbingly, among these ads, the tobacco industry has found a way to infiltrate the screens of youth with flashy, colourful promotions for their products. These ads are meticulously designed to appeal to youthful sensibilities, making smoking and vaping seem attractive and harmless.

The Rising Threat of New and Emerging Tobacco Products

Traditional cigarettes are no longer the only threat. The rise of electronic cigarettes, oral nicotine products etc., have introduced a new dimension to the problem. These products are often marketed as safer alternatives or cessation tools, but they pose significant risks, especially to young, developing brains. The appeal of e-cigarettes to adolescents is particularly troubling. A 2022 study of 47 countries found that 8.6% of youth reported using e-cigarettes in the last 30 days. In the Caribbean a handful of countries are regulating e-cigarettes including Jamaica, Guyana, and Barbados, who have banned e-cigarette use in public places. Antigua and Barbuda, along with Suriname, have taken an even stronger stance by prohibiting the import, distribution, and sale of e-cigarettes altogether. Despite these measures, the Global Youth Tobacco Survey (GYTS) data showed current use of e-cigarettes among 13-15-year-old students ranging from 4.0% in Antigua and Barbuda to 17.2% in Trinidad and Tobago. Trinidad and Tobago has the second-highest rate of youth e-cigarette use in all of the Americas, following the United States. Traditional cigarette smoking among youth still continues to be a major concern because they are regarded as the smokers of tomorrow as three to four out of every ten ever-smokers, in the Caribbean region, initiated smoking before the age of 10 years.

Tobacco use, in any form, is linked to numerous health risks, including an increased likelihood of developing cancer, heart disease, and respiratory conditions. Electronic nicotine delivery systems (ENDS) or e-cigarettes containing nicotine are particularly harmful as they can lead to nicotine addiction, which adversely affects brain development in adolescents, potentially impairing memory, concentration, and learning abilities. Even e-cigarettes without nicotine or electronic non-nicotine delivery systems (ENNDS) can be dangerous due to the inhalation of harmful chemicals and flavourings that can cause respiratory issues and other health problems. Nicotine pouches, though marketed as a safer alternative, still deliver highly addictive nicotine and can lead to dependency, oral health issues, and an increased risk of transitioning to other tobacco products. The link between vaping and mental health issues is becoming increasingly evident.  A U.S study published in 2019, examined the association between e-cigarette use and depression and found that current e-cigarette users had more than twice the odds of reporting a history of clinical depression compared to those who had never used e-cigarettes. Specifically, current e-cigarette users were 2.10 times more likely to report depression, with the odds increasing with the frequency of use.

The Tobacco Industry’s Pervasive Marketing Strategies

As a youth tobacco control advocate, I am especially concerned with the tobacco industry’s persistent marketing in the Caribbean. With social media being widely used, especially among young people, tobacco companies are leveraging platforms like Facebook, Instagram, X formerly known as Twitter, and TikTok to promote their addictive products. These companies, having honed their skills in targeting youth, are now implementing online marketing strategies that are both sophisticated and pervasive. These strategies include lifestyle campaigns that link tobacco and nicotine with freedom, rebellion, and youthfulness, creating an appealing image that resonates strongly with adolescents. Additionally, tobacco companies are compensating social media influencers to endorse their brands subtly, seamlessly integrating their products into the daily lives of young followers. A report from the Campaign for Tobacco-Free Kids, titled #SponsoredByBigTobacco, reveals that promotional content for Velo, IQOS and Vuse (products by British American Tobacco and Phillip Morris) has accumulated over 3.4 billion views on social media and reached more than 150 million young people under the age of 25.

The tobacco industry is also using carnivals and festivals as a marketing opportunity. For example, British American Tobacco heavily promoted their vaping device, Vuse, during the Jamaican Carnival. They used social media to advertise a promotion where purchasing Vuse products gave participants a chance to win a t-shirt package to Play Mas. They even had their own carnival truck and tents where Vuse products were prominently displayed. This type of marketing not only targets young adults but also attracts young children and teenagers, embedding the presence of tobacco products in the festive and culturally significant atmosphere of carnival. This concerted effort has allowed Big Tobacco to reach a massive young audience, making addictive products seem normal and even desirable through extensive in-person and social media exposure.

From conversations with my peers, it’s clear why vapes are so enticing: the wide range of flavours, their trendy image, affordability, and the misleading perception that they are harmless.Companies like Philip Morris and the West Indian Tobacco Company Limited have capitalised on these perceptions by advancing their own “smoke-free vision” – marketing their vaping devices as “risk-reduced alternatives” and a way for adult smokers to quit tobacco. However, the evidence shows a different story. Studies have shown that youth often misunderstand these claims, and are led to believe that these products are without harm, leading to an increased likelihood of nicotine and tobacco-use initiation.

The Urgent Need for Comprehensive Regulations

The WHO’s newly published report, Hooking the Next Generation: how the tobacco industry captures young customers, has revealed the strategies employed by the tobacco and nicotine industry to entice youth. Recent statistics show that 85% of 15–30-year-olds have been exposed to e-cigarette advertising, with higher exposure linked to increased use. In light of this data, Caribbean youth are joining the call to action on World No Tobacco Day 2024, urging our governments to protect us from the manipulative tactics of the tobacco industry. This call to action aims to raise awareness and mobilise efforts to prevent the targeting and exploitation of young people by these harmful products and deceptive strategies. It is crucial to reveal how the industry markets new products as “reduced risk” alternatives, misleading young consumers. Moreover, comprehensive regulations are essential to protect youth from new tobacco and nicotine products. Extending smoke-free laws to include e-cigarettes and other novel products, as well as banning flavours that appeal to young users, are vital steps in preventing the renormalization of smoking behaviours.

In collaboration with the HCC, I developed the Youth Tobacco Advocacy Portal, which serves as a platform to share information, strategies, and resources to combat tobacco use and influence policy changes. For WNTD 2023, the HCC launched a report developed in collaboration with PAHO:, Vaping Among Adolescents and Youth in the Caribbean Situation, Policy Responses and Recommended Actions, which provides guidance to Caribbean governments. Governments play a crucial role in this fight and should take decisive actions to safeguard youth. Based on this report’s recommendations,  I urge our governments to implement and enforce the WHO Framework Convention on Tobacco Control (FCTC):

  • Implement and enforce comprehensive bans on tobacco advertising, promotion, and sponsorship (TAPS), including guidelines for digital and cross-border marketing, to prevent tobacco companies from exploiting new media platforms to target youth.
  • Raise prices and taxes on tobacco and nicotine products to make them less affordable and less accessible to young people.
  • Strictly enforce bans on the sale of tobacco and nicotine products to children.
  • Address tobacco industry interference and conflict of interest. The tobacco industry’s persistent interference in policy-making demands stringent measures. Rejecting any partnerships or agreements with the industry is paramount, given their history of undermining tobacco control efforts. Moreover, enhancing transparency in the industry’s lobbying and marketing practices is imperative to safeguard policy-making processes from undue influence. Good governance policies must be enacted to ensure transparency and address conflict of interest and industry interference, aligning with the principles outlined in the 2023 Bridgetown Declaration on NCDs and Mental Health and Article 5.3 of the WHO FCTC.
  • Update legislation to include ENDS and ENNDS to address the evolving landscape of tobacco products and ensure comprehensive protection for youth.

As we commemorate World No Tobacco Day 2024, we must remember that safeguarding our youth from the tobacco industry’s predatory practices is non-negotiable. The rise of new and alluring tobacco products, coupled with the relentless barrage of social media marketing, underscores the urgency of our response. Our governments must heed the call to action, enacting comprehensive regulations and enforcing existing frameworks like the WHO FCTC with unwavering determination. By prioritising transparency, accountability, and the well-being of our youth, we can dismantle the tobacco industry’s web of deceit and protect future generations from the grip of addiction and disease.

Let this day serve as a catalyst for change, uniting us in our resolve to build a nicotine and tobacco-free Caribbean.

Dorial Quintyne is the Project Assistant for the Healthy Caribbean Coalition’s Healthy Food Policy Project and holds a Master’s degree in Public Health from Seoul National University, South Korea. She is a passionate youth tobacco control advocate and an active member of Healthy Caribbean Youth.

The post Did You Know The Tobacco Industry Has A Hold On Our Youth? appeared first on Healthy Caribbean Coalition.

10 months 3 weeks ago

Healthy Caribbean Youth, News, Slider

PAHO/WHO | Pan American Health Organization

PAHO and German Development Agency GIZ sign agreement to advance regional health priorities, with special focus on digital transformation

PAHO and German Development Agency GIZ sign agreement to advance regional health priorities, with special focus on digital transformation

Cristina Mitchell

30 May 2024

PAHO and German Development Agency GIZ sign agreement to advance regional health priorities, with special focus on digital transformation

Cristina Mitchell

30 May 2024

10 months 3 weeks ago

KFF Health News

KFF Health News' 'What the Health?': Waiting for SCOTUS

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.

June means it’s time for the Supreme Court to render rulings on the biggest and most controversial cases of the term. This year, the court has two significant abortion-related cases: one involving the abortion pill mifepristone and the other regarding the conflict between a federal emergency care law and Idaho’s near-total abortion ban.

Also awaiting resolution is a case that could dramatically change how the federal government makes health care (and all other types of) policies by potentially limiting agencies’ authority in interpreting the details of laws through regulations. Rules stemming from the Affordable Care Act and other legislation could be affected.

In this special episode of “What the Health?”, Laurie Sobel, an associate director for women’s health policy at KFF, joins host Julie Rovner for a refresher on the cases, and a preview of how the justices might rule on them. 

The cases highlighted in this episode:

Previous “What the Health?” coverage of these cases:

Where to find Supreme Court opinions as they are announced:

Click to open the Transcript

Transcript: Waiting for SCOTUS

[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.] 

Mila Atmos: The future of America is in your hands. This is not a movie trailer, and it’s not a political ad, but it is a call to action. I’m Mila Atmos and I’m passionate about unlocking the power of everyday citizens. On our podcast “Future Hindsight,” we take big ideas about civic life and democracy and turn them into action items for you and me. Every Thursday we talk ato bold activists and civic innovators to help you understand your power and your power to change the status quo. Find us at FutureHindsight.com or wherever you listen to podcasts.

Julie Rovner: Hello, and welcome back to “What the Health?” I’m Julie Rovner, chief Washington correspondent for KFF Health News. We’re taping this week on Wednesday, May 29, at 1 p.m. As always, news happens fast and things might’ve changed by the time you hear this. So here we go.

Because it’s a holiday week and health news is a little bit slow, we’re going to do something a little different. It’s about to be June, and that means the Supreme Court is going to issue opinions in some of the biggest cases argued this past term, including two abortion-related cases and one that could literally disrupt the way the entire federal government operates. I’m not sure I remember all the details of these cases, even though we have talked about them all on the podcast. So I’ve asked someone here to remind us what they’re about and give us a preview of how the court might rule in some of them. Laurie Sobel is associate director for women’s health policy here at KFF, and one of our top in-house legal experts. Laurie, welcome to “What the Health?” Thanks for joining us.

Laurie Sobel: Hi, Julie. It’s great to be here.

Rovner: So I thought we’d take the cases in the order they were argued before the court, although I know that’s not necessarily the order that we will see the opinions issued in. First up: In January, the justices heard arguments in two cases about, of all things, herring fishing. Loper Bright Enterprises v. Raimondo and Relentless Inc. v. Department of Commerce. But these cases are about a lot more than herring and could affect a lot more than the Department of Commerce, right?

Sobel: Absolutely. These cases are about what’s called the Chevron doctrine [deference], which requires courts to defer to an agency’s interpretation of a law when the law is silent or ambiguous and the agency’s interpretation is reasonable.

Rovner: And what would an example of that be?

Sobel: Oh, there’s many, many examples. Essentially, Congress doesn’t fill in the details of many laws, and they rely on agencies to fill in those details, assuming that the agency has the expertise to figure out what those details might be. And also, many times the details change as new scientific evidence becomes available or there’s changed circumstances, or there’s a pandemic or something in which the agency needs to respond to.

Rovner: This is basically the entire federal regulatory process we’re talking about here, right?

Sobel: That’s correct.

Rovner: And in health care, there’s a lot of places that regulation affects.

Sobel: Absolutely. So Congress relies on the agencies to implement laws, the ACA [Affordable Care Act], Medicare, Medicaid, CHIP [Children’s Health Insurance Program]. So there’s a lot in health care. In addition, Title X is regulated by the Office of Population Affairs, and those also have regulations. So overturning Chevron would make it very difficult for Congress to continue to rely on agencies to fill in these gaps and to react to real-time situations.

Rovner: And there’s private entities that get regulated, are freaked out by the possibility that they won’t be able to rely on the agencies either.

Sobel: Absolutely. So everything from payment rates to providers and hospitals to negotiating prescription drug prices for the Medicare program. The ACA, I think, has probably more regulations than most laws. And relationship — we’ll talk about the FDA [Food and Drug Administration] in the next case, but the FDA also sets out regulations as does CDC [Centers for Disease Control and Prevention], and we really rely on those agencies to have the scientific expertise to react to the situation. So if Congress has to either fill in all the gaps, which is by most people’s assessment impossible, it might really stall how things get implemented and/or create a whole lot of new litigation.

Rovner: And I would say it would give courts a whole lot more authority than they have now, right?

Sobel: Certainly. So right now, the rule is that the agency’s interpretation stands as long as the law is ambiguous or silent and the agency’s interpretation is reasonable. This would give that power back to the courts to then guess what Congress meant or to interpret what Congress meant.

Rovner: Somebody I was talking to about this case suggested that, I hadn’t really thought about before, that if Chevron were to get struck down, that those who had sued over regulations and lost might be able to go back and reopen those cases. I mean, it could just be a flood of litigation.

Sobel: Absolutely. And that came up during oral argument about what would that mean for all the settled cases. And both sides offered different interpretations with the solicitor general arguing that it would really open up this can of worms to tons of litigation, and the plaintiffs essentially saying, “No, no, no, we could let those all stand and just going forward, the Chevron deference would be undone.” And there were some hints that maybe some compromises like that between the justices as they were talking.

Rovner: Exactly. You’re anticipating my next question, which is did we get any hints from the oral arguments about where they might be going with this case? It’s hard to imagine them just completely overturning Chevron.

Sobel: It is hard to imagine, but there are some justices that have been known to wanting to overturn Chevron for quite some time. So in that category I would put Justices [Clarence] Thomas and [Samuel] Alito, as well as [Neil] Gorsuch, as justices that have really been critical of the Chevron deference. Justice [Brett] Kavanaugh highlighted that the rules change when administrations change, and so he tried to counter the argument that there’s a reliance on Chevron for stability. He said, “Wait, wait, wait a minute. Every time there’s a new president, the rules change. So what kind of stability is that?”

Chief Justice [John] Roberts and [Justice Amy Coney] Barrett were really harder to read, and that might be where the decision relies on, where they come out and whether or not they’re able to forge a compromise with the three liberal justices who indicated support for keeping Chevron; both because of precedent, as well as they pointed out examples where they said, “We’re not subject matter experts here. We don’t want to be making these decisions.” Justice [Elena] Kagan was talking about AI and how that would change, and “we really don’t want to be in the position of Justice Kagan figuring out how that should be regulated.”

Rovner: Well, that seems to be an excellent segue to the next case, which is an abortion case concerning the availability of the abortion pill mifepristone. The case, which was argued in March, is called Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration. Let’s start, because it’s about to become important, with what is the Alliance for Hippocratic Medicine? And what did their members have against the abortion pill?

Sobel: Well, the Alliance for Hippocratic Medicine is a newly formed anti-abortion advocacy coalition. It was formed specifically for this litigation. And they contend that they have members, which are doctors and organizations and associations, in Texas and around the country, who have treated and will continue to treat people who have experienced a complication from medication abortion. So to be clear, none of their members prescribe mifepristone. They don’t believe in abortion. They don’t want to have anything to do with abortion. But their contention is that they are injured based upon having to divert their time and resources away from their regular patients when they have to treat somebody who has had a side effect from mifepristone. Similarly, the association and organizations contend that they’ve had to divert their time to educate people about the dangers of medication abortion.

Rovner: So those are the plaintiffs. And, as you mentioned, some of them are in Texas and they sued in Texas very specifically to get a certain judge, right?

Sobel: Yes, to get Judge [Matthew] Kacsmaryk, who is known for being friendly to these types of cases.

Rovner: So Judge Kacsmaryk, who as you say, is known to be friendly to these types of cases, originally ruled that mifepristone’s entire approval should be rescinded. It was approved in the year 2000, so it’s been on the market for quite a long time. But that’s actually not what’s on the table at the moment before the justices. Explain how we got there.

Sobel: So that decision was then appealed to the 5th Circuit, and the 5th Circuit said, “We’re not going to roll back the original approval of mifepristone to the year 2000, but instead we’ll roll back the requirements to 2011 and say that those are the rules that should be enforced, and that the FDA exceeded their authority in changing the rules since 2011.”

Rovner: And some of those changed rules basically made it easier to get, and you could use it a little bit later into pregnancy because it was found to be safe, right?

Sobel: Exactly. So what those new rules have done is said that you can use it up to 10 weeks instead of seven weeks, that you don’t have to be in person to receive it. So the newest rules have opened up the possibility of using it for telehealth abortion, and also for pharmacists prescribing it. And so if the Supreme Court were to affirm the 5th Circuit’s decision, that would eliminate these new protocols the FDA has established in removing the in-person dispensing requirement, permitting telehealth abortions, and establishing the process for pharmacies to become certified to dispense mifepristone. In addition, it would roll back the gestational ages you just said, from 10 weeks to seven weeks, which is significant because, according to the CDC data, more than 4 in 10 medication abortions occur at seven weeks or later.

Rovner: I was going to say, and yeah, this could be super disruptive. I mean medication abortion is now more than half of all abortions in this country.

Sobel: Oh, it’s two-thirds.

Rovner: So without banning it, making it harder to get could have a big impact.

Sobel: Oh, absolutely. Medication abortion now accounts for nearly two-thirds of all abortions, and telehealth abortions have become very common, from the latest data that we have from WeCount, 1 in 5 abortions was provided via telehealth in December of 2023. So that’s one in all abortions, not one in medication abortions. So that’s quite a big number.

Rovner: Now, this case, even though it could be very disruptive to abortion, is about a whole lot more than abortion. Drugmakers in general seem pretty concerned by the idea of judges making scientific decisions that overrule the FDA. This hearkens back to the last case we talked about, right?

Sobel: Oh, absolutely. So this is the first case to ask the Supreme Court to overrule an FDA decision that a drug is safe and effective. So the outcome of this case could really have very far-reaching implications for the FDA’s authority to continue to regulate not only mifepristone, but a wide range of other drugs. And most likely the other drugs that are perceived to be controversial — gender-affirming care or PrEP — those are the drugs that are most likely to be litigated if this door is opened.

Rovner: And I know that there’s nothing that makes drugmakers … I mean, patent issues and drugmakers and court issues are hard enough, the idea that they could be granted approval by the FDA and then somebody could just come in and sue and make that go away.

Sobel: Oh, absolutely. This got the attention of the entire industry. There were many, many amicus briefs that were filed.

Rovner: So normally you can’t really tell from the oral arguments, as we said, how the justices are leaning. But in this case, the justices seemed fairly transparent about where we think they’re going to go. What are we expecting here?

Sobel: Yes. I mean, as I said before, it’s always dangerous to read the tea leaves too much, but this did seem more transparent than most, and that most justices seemed not convinced that the plaintiffs in this case have legal standing, which requires that you have an injury and that injury can be addressed by what the court decides. So even assuming that the plaintiffs have an injury, the question is what would happen if we roll back the rules that the FDA has back to 2011? Does that make it more or less likely that these plaintiffs would see people with side effects of mifepristone? It’s not really clear. In addition, many of the justices, including Justice Barrett, really pushed back on the lawyer representing the Alliance for where in the doctors’ affidavits it said they were actually participating in something they objected to. Notably, not really about necessarily this case, but about what might come up in the future, both Justice Thomas and Alito did bring up the Comstock Act and signaled that they would uphold the enforcement of the Comstock Act, pretty much inviting a future case or a future administration to enforce the Comstock Act.

Rovner: As much as we’ve talked about it, remind us again what the Comstock Act is.

Sobel: Sure. So it’s a law from 1873, which was an anti-obscenity law, and as part of it, it banned the mailing of any drug or device or instrument that could be used for abortion.

Rovner: Well, I guess during the entirety of Roe [v. Wade], it was irrelevant, right? Because abortion was legal,

Sobel: Right. And it’s been dormant. I mean, we can’t find any enforcement in any modern era.

Rovner: Yes, so it goes back a long ways, but it’s top of mind for a lot of people.

All right, moving on to our last case. On April 24, the court heard Idaho v. United States and Moyle v. United States, both of which challenged the federal government’s interpretation of the Emergency Medical Treatment and Active Labor Act, EMTALA, to override Idaho’s near-complete abortion ban, at least in medical emergencies. Let’s start by explaining what EMTALA is and how it relates to abortion?

Sobel: Sure. So EMTALA requires hospitals that participate in Medicare, which is pretty much every acute hospital, to provide stabilizing treatment within the hospital’s capability when there’s an emergency medical condition, which includes when the absence of immediate medical attention could reasonably be expected to place the health of the individual in serious jeopardy or serious impairments of bodily functions. So it was really intended as an anti-dumping law initially so that people who were uninsured weren’t just transferred or sent away to another hospital because they didn’t have the capacity to pay.

Idaho’s abortion ban only has an exception for life. It doesn’t have an exception to preserve the health of the pregnant person. And so the Biden administration sued Idaho and said this law then, essentially, puts these hospitals that have this requirement, because they accept Medicare payments, to stabilize patients. And when that care includes abortion care, they’re required to provide that under federal law. So the question is, does the EMTALA preempt the Idaho abortion ban?

It’s clear from the oral argument that Idaho’s position is that there is no conflict because they read into the EMTALA law that “within the hospital’s capability” includes the laws of Idaho and that Idaho gets to set the standard of care, and that that’s up to states, not up to the federal government. Whereas the federal government, the Biden administration’s position, is that, no, EMTALA specifically was an antidumping law, and that includes stabilizing all patients regardless of the care. And we don’t have to say including abortion in order for it to include abortion, it includes all care that’s required to stabilize patients.

Rovner: Of course, a lot of anti-abortion activists will say that the only time abortion is medically necessary is when it threatens life and that would be covered. But we’re seeing that that’s not necessarily the case, right? I mean, we’re seeing individual instances of this these days.

Sobel: Yeah. I mean, we know from Idaho that many patients have been helicoptered out of the state into nearby states that also have some abortion restrictions but just aren’t as restrictive as Idaho is, because they’re going to become septic or they’re going to lose kidney function, or they’re going to lose their reproductive organs. So they’re not in danger of losing their life immediately, but they’re in danger of losing serious bodily functions.

The other question that came up during oral argument was about just how imminent the life needs to be. And this comes down to how this is putting doctors in a pretty uncomfortable place. So yes, the doctors are permitted to provide abortion care in Idaho when they can certify in good faith that without the abortion care, the person’s life is endangered. But they’re concerned that, after the fact, attorneys for the state could come back and say, “Oh, wait a minute, that wasn’t your really good-faith decision and we’re going to prosecute you and we’re going to bring in our own expert.” And the question is really, how much should doctors have on the line? It’s a criminal statute, so there’s jail time involved. Of course, there’s a loss of license. And so how far out should doctors be required to go? And this is, again, it’s making people really uncomfortable, and there are anecdotes of people leaving the state because of this and not feeling comfortable practicing there.

Rovner: More than anecdotes of people leaving the state, there are people who come forward and said they’re leaving the state. And as a result, some hospitals are having to shut down their OB services. I mean, because when the doctors, OB-GYNs who are leaving, so in the ironic position of people who are having babies not being able to find someone who can deliver their baby at the same time.

Sobel: Right, right.

Rovner: That’s obviously one ramification within Idaho, but there could be ramifications outside just on the idea: Isn’t federal law supposed to trump state law? Isn’t that sort of a basic foundation of how we work?

Sobel: Yes. The supremacy clause is pretty basic when you go to law school. So yes. And I think how they word this decision will be very interesting to see because it’s a question of, is there a conflict or is there not? And the attorneys for Idaho were basically suggesting that there’s no conflict. So you don’t even need to say that there’s a preemption. You just have to find that there’s no conflict between Idaho law and EMTALA.

However they rule, if they rule for Idaho and say that you’re allowed to continue having this abortion ban that only has a life exception with no health exception, immediately, there’s four additional states with abortion bans that do not make exceptions for health as well. And those states are Arkansas, Mississippi, Oklahoma, and South Dakota. So in those states, like Idaho, a hospital cannot legally provide an abortion as stabilizing treatment when a person presents with a health endangerment and not a life endangerment. And so again, those risks can include sepsis, kidney failure, loss of fertility, they’re serious risks, even though they may not be life-threatening at the moment.

And even in the states that do have exceptions for health, we have seen that those exceptions are often very narrow and vague and hard to be implemented in real time. So pregnant people can still be denied emergency abortion care that’s needed to preserve their health, even in states that have a health exception. And if EMTALA doesn’t act as a backstop to say, “But wait, hospital, you’re violating this federal law,” then people are stuck with the state law that is narrow and vague.

Rovner: So I mean, overturning Roe, the justices says, “Oh, great, we won’t have to deal with abortion anymore. It’s all about the states.” But as we can see, it’s not all about the states. The Supreme Court is going to have to continue to deal with this issue.

Sobel: Right. Definitely.

Rovner: All right, well, finally, just a couple of housekeeping issues. We don’t actually know when these decisions will come, right? People who don’t follow the court on a regular basis often think that opinions are scheduled the same way oral arguments are, but it’s always a surprise.

Sobel: Unfortunately, they are not. Right now, the court lists their decision days on their website, which is on their calendar. Right now Thursdays seem to be the popular day, they have Thursdays through June listed. They most likely will add more decision days. On decision days, they start posting decisions at 10 a.m. Eastern Time, and you can follow along either on the Supreme Court’s website or many people go to SCOTUSblog, which also has a live blog that interprets some of what’s happening for people who are new to the court.

Rovner: And I will put both of those links in the show notes. Laurie Sobel, this has been so helpful. Thank you so much for joining us.

Sobel: Thank you for having me, Julie.

Rovner: OK, that is our show. 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 technical guru, Francis Ying, and our fill-in editor this week, Rebecca Adams. As always, you can email us your comments or questions. We’re at whatthehealth@kff.org, or you can still find me at X @jrovner. We will be back in your feed next week with the news. Until then, be healthy.

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10 months 3 weeks ago

Courts, Multimedia, Pharmaceuticals, States, The Health Law, Abortion, FDA, Idaho, KFF Health News' 'What The Health?', Podcasts, Women's Health

PAHO/WHO | Pan American Health Organization

Tobacco and nicotine industry tactics addict youth for life

Tobacco and nicotine industry tactics addict youth for life

Cristina Mitchell

30 May 2024

Tobacco and nicotine industry tactics addict youth for life

Cristina Mitchell

30 May 2024

10 months 3 weeks ago

Health – Demerara Waves Online News- Guyana

Health ministry rolls out therapy to help people quit smoking tobacco products

The Ministry of Health’s Chronic Disease Unit on Wednesday handed over a quantity of nicotine replacement therapy (NRT) supplies to the Eccles Health Centre to support smoking cessation efforts. This initiative was done in observance of World No Tobacco Day which will be observed on May 31st, and aims to raise awareness about the dangers ...

The Ministry of Health’s Chronic Disease Unit on Wednesday handed over a quantity of nicotine replacement therapy (NRT) supplies to the Eccles Health Centre to support smoking cessation efforts. This initiative was done in observance of World No Tobacco Day which will be observed on May 31st, and aims to raise awareness about the dangers ...

10 months 3 weeks ago

Health, News, Ministry of Health's Chronic Disease Unit, nicotine dependence, tobacco users, World No Tobacco Day

Health Archives - Barbados Today

Senator questions healthcare, education priorities

An independent senator has raised concerns about whether healthcare and education are receiving sufficient prioritisation and resources from the government, despite being vital sectors.

In the Senate debate on the Child Protection Bill, Senator Andrew Mallalieu suggested there was a decline in healthcare and education with high levels of charitable donations to the healthcare system, and private schools becoming the main choice of students seeking secondary education.

But Senator Lisa Cummins, the leader of government business in the Senate, pushed back on the real estate executive’s charges, saying healthcare and education have been public policy priorities since independence in 1966.

Senator Mallalieu referenced key points from the United Nations Convention on the Rights of the Child, which is cited in the child protection legislation that was passed last week in the lower House of Assembly.

“Point 24 of the convention states children have the right to the best possible healthcare,” he said. “Point 28 says every child has a right to education, with primary education being free…. Point 29 notes children’s education should help them fully develop their personalities, talents and abilities.”

While acknowledging the convention sets minimum children’s rights standards which countries can exceed, Senator Mallalieu questioned the Mottley administration’s priorities.

“Having understood that, I worry greatly about what our priorities have been,” he declared.

On healthcare, the senator said: “We hear of difficulties in getting care at hospitals, polyclinics, wherever it might be. I worry when I see the amount of private charity money that has to go into our healthcare system to keep it running.”

Regarding education, the businessman lamented a perceived decline: “My recollection of the 11-Plus is we all aspired to go to a public school, that’s where the best secondary education was available…. Today, that’s completely reversed. The first choice is not to go into the public school system, because it’s a difficult place. If you’re not a top child and you can’t teach yourself, you will possibly not get a good education there.”

Senator Mallalieu stressed the importance of better working conditions and higher pay for teachers and healthcare workers: “If it’s going to be your top priority, I would think the people who work in those areas would be our smartest people who are paid the most and work in the best conditions, and I am fearful today that that is not true.

“In our school system, it is not the best facilities. Our teachers are not paid the highest salaries. Our doctors, nurses, healthcare providers are not working in the best conditions,” he lamented.

But defending the administration’s record, Senator Cummins said education and healthcare have been the two largest areas of public spending for successive governments since Independence.

It was “misleading to attempt to say that those have not been government priorities”, she said.

Acknowledging historical investment in health and education, Senator Mallalieu called for even greater emphasis: “Perhaps I would like to see even more prioritisation.”

He noted recent positive steps such as the government’s acquisition of the defunct Ursuline Convent private school, and partnerships with Ivy League universities in the US, including a memorandum of understanding with Columbia University’s teaching college.

Reiterating his support for the Bill and the need for an ongoing focus on the UN children’s rights convention, the independent senator said: “I do hope that we will focus on these as we have done and will continue to do, so that our children can have the best education and can look after the [Senate] president and I in our old age.”

 

The post Senator questions healthcare, education priorities appeared first on Barbados Today.

10 months 3 weeks ago

Health, Local News, Youth

BVI News

Health Ministry: No mother-to-child transmission of HIV, syphilis in BVI


The Dr D Orlando Smith Hospital in Road Town


The Dr D Orlando Smith Hospital in Road Town

The Ministry of Health has moved to defend the BVI’s track record, stating that the territory has been successfully preventing mother-to-child transmission of HIV and syphilis for the past five years.

The Ministry’s defence of the territory’s reduction efforts for these two deadly diseases come amid reports that Belize, Jamaica, and St Vincent and the Grenadines are the latest countries in the Caribbean to be commended for eliminating mother-to-child transmission of HIV and syphilis.

The BVI was not named on the World Health Organization’s (WHO) list and when BVI News contacted the Ministry, Chief Nursing Officer Jascinth Hannibal said the territory has a great track record in this area.

“For more than five years, there were no mother-to-child transmissions in the territory,” Hannibal told BVI News. “We follow the World Health Guidelines for the elimination initiative where mothers are tested during the antenatal process while pregnant, as well as prior to delivery for both HIV and Syphilis.”

She explained that once HIV or syphilis is identified, mothers are offered treatment that makes the HIV undetectable and this lowers the risk of transmission during the birth process.

“All our births occur in the hospital setting where there are infection control protocols that minimize the risk of transmission to the infant. After birth, the infant is also monitored following the WHO Guidelines that prescribe a series of testing to identify HIV, [and outlines] prevention and treatment modalities to help the infant to thrive,” Hannibal explained to BVI News.

Anguilla, Cayman Islands, Montserrat and Bermuda all received recognition from the WHO for eliminating mother-to-child transmission of both diseases a few years ago.

Another Caribbean country on the list is Cuba, which made history by becoming the first country in the world to achieve the dual elimination of HIV and syphilis. Antigua and Barbuda, St Kitts and Nevis and Dominica are also on the list.

10 months 3 weeks ago

All News

Health – Demerara Waves Online News- Guyana

Fire destroys health ministry’s mosquito control bond

A Ministry of Health bond that stored mosquito fogging chemicals and other vector control supplies was Tuesday afternoon destroyed by fire, the Guyana Fire Service said on Wednesday. “Vapor from gasoline tank came into contact with heated exhaust pipe from fogging machine same ignited and exploded,” the fire service told Demerara Waves Online News. Residents ...

A Ministry of Health bond that stored mosquito fogging chemicals and other vector control supplies was Tuesday afternoon destroyed by fire, the Guyana Fire Service said on Wednesday. “Vapor from gasoline tank came into contact with heated exhaust pipe from fogging machine same ignited and exploded,” the fire service told Demerara Waves Online News. Residents ...

10 months 3 weeks ago

Health, News, fire incident, Ministry of Health, Vector Control Service Bond

Health | NOW Grenada

Care-Transition Clinic accepting applications online for General Nursing Programme associate degree

Care-Transition Clinic is accepting applications online for its General Nursing Programme Associate Degree, expected to commence on 19 August 2024. Registration closes on 30 June and a payment plan is available.

10 months 3 weeks ago

Education, Health, PRESS RELEASE, ambika Joseph, associate degree, care-transition clinic, curlan campbell, general nursing programme, nurse, nursing and midwives council of grenada

Health Archives - Barbados Today

New chief eyes holistic healthcare reforms

Newly appointed chief executive Neil Clark has outlined a comprehensive vision to overhaul healthcare delivery at the Queen Elizabeth Hospital. 

Clark, a seasoned healthcare executive who took up his post on April 2, laid out plans to address pressing issues and ensure “citizens receive the quality care they deserve”.

Newly appointed chief executive Neil Clark has outlined a comprehensive vision to overhaul healthcare delivery at the Queen Elizabeth Hospital. 

Clark, a seasoned healthcare executive who took up his post on April 2, laid out plans to address pressing issues and ensure “citizens receive the quality care they deserve”.

A key priority is improving the long-troubled accident and emergency (A&E) department, which Clark acknowledged had been blighted by overcrowding before its recent expansion. “It was very cramped, very tight. It didn’t look good. It didn’t feel good. Too many patients waiting, family members with them,” he said. “Working in that department must [have been] extremely stressful for the staff.”

But Clark insisted enlarging A&E alone would not solve the systemic problems. “It’s not just about having the A&E department the right size. What happens in the A&E is a consequence of a whole system, a whole healthcare system.”  

The CEO said he intends to work with polyclinics, private clinics and the Ministry of Health to educate the public and reduce unnecessary A&E visits. “A&E departments are for accidents and emergencies. Not all the patients in the A&E department are accidents or emergencies,” he said. “Some of those emergencies could have been avoided … people’s strokes, people’s heart attacks, and people’s chronic conditions could be managed better, stop them coming into the hospital when they’re acutely ill.”

Clark outlined a “holistic approach” to improving patient flow from admission to discharge, calling for coordinated efforts across departments like pathology and radiology to optimise operational efficiency. He also plans to review procedures for dealing with escalating A&E demand.

Lengthy waiting times for outpatient appointments and diagnostics are another “challenge”, Clark said, citing a lack of centralised data collection. But he revealed a new health information system will be implemented later this year to identify and address bottlenecks.

“We don’t have a health information system, so it’s quite hard sometimes to capture information on the waiting times,” he said. “We should be going out for tender for that system this summer, so we can bring in a system that will help us then gather the information to make sure that we’re very clear on where the pain points are.”

Clark also plans to closely scrutinise the functioning of the hospital’s wards to ease bottlenecks preventing patients from being transferred out of A&E.

“If the A&E department’s full because it can’t move patients from the department onto a ward, upstairs into the medical beds, we need to make sure that the wards are functioning as efficiently and as effectively as possible,” he said.

“So we’ve already started some work with the medical leads and how we can maybe manage the medical beds slightly differently to improve flow through those inpatient beds.”

At the other end of the care pathway, Clark said he must collaborate with external parties to ensure discharged patients have appropriate places to go, highlighting the need for “where will the elderly for care patients go and what are the different options”.

To drive these ambitious reforms, the new CEO has introduced “balanced scorecards” to identify top priorities and risks. He has also tasked the chief operating officer with developing “plans for how we’re going to tackle some of those areas” including outpatient waits, theatre delays and cancellations, and A&E waiting times.

Clark insisted data analysis would be central, saying: “I’ve already requested and redirected the chief operating officer to focus on what I call patient flow, how patients flow through the system and quality outcomes.”

The CEO, who has hit the ground running just weeks into his tenure, projected confidence that the QEH can turn around its fortunes despite long-standing issues.

“As a team of people, we can find solutions to this and I’ve seen that done in different places before,” Clark affirmed. 

(RG)

The post New chief eyes holistic healthcare reforms appeared first on Barbados Today.

10 months 3 weeks ago

Health, Local News

Health News Today on Fox News

Michigan mom: ‘I had a stroke at 39 — and the warning signs weren’t what you’d expect’

Jenna Gibson was just 39 when she was training for a marathon five years ago — but her plans were cut short by a stroke that almost took her life.

Jenna Gibson was just 39 when she was training for a marathon five years ago — but her plans were cut short by a stroke that almost took her life.

Nearly 60% of stroke deaths occur in women, according to a recent study by Mayo Clinic — and now Gibson, a Michigan mother of two, aims to help others to be more aware and prioritize their health.

"Once I learned that strokes are happening to younger people, I had to share my story," she told Fox News Digital. 

5 WOMEN’S HEALTH TIPS TO PREVENT AND DETECT STROKES, ACCORDING TO CARDIOLOGISTS

"In most cases, strokes are preventable if you know what to look for."

On the day of Gibson’s stroke, she was feeling great.

It was a beautiful day, she’d nailed a presentation at work, and she was enjoying a walk outside with her mother after dinner.

"We were talking about how I was training for the Detroit marathon for my 40th birthday, and then all of a sudden, out of the blue, it felt like I was hit with a ton of bricks," she told Fox News Digital.

DOG ALERTS FAMILY, SAVES TEXAS TEENAGER FROM LIFE-THREATENING STROKE: 'KEEPING GUARD'

Gibson stopped walking, then suddenly fell over into the grass. 

Her mother thought she was joking at first. "She actually took a picture of me lying in the grass, saying, ‘C’mon, get up, what are you doing?’"

Her mother helped her up, but Gibson couldn’t walk straight. 

"I felt like I was drunk — something just wasn't right," she said.

Even so, Gibson did not experience any of the textbook symptoms of a stroke, such as the facial droop, severe headache or vision disturbances.

They made it back home, where Gibson assumed she was having a migraine. She took some headache medicine and went to bed.

"A couple of hours later, I woke up and still didn't feel right — I couldn't get out of bed, I couldn't move," she recalled. 

TIAS AND MINI-STROKE RISKS: CARDIOLOGIST SHARES WARNING SIGNS AND PREVENTION TIPS

That’s when they headed to the emergency room. Gibson’s mother told the medical team that her daughter was having trouble walking and might be having a stroke.

"They checked me over, did all the tests, and didn't see the typical signs that they would be looking for," Gibson said. "Part of it was because I was young."

She added, "I didn't have the facial droop. I could walk, although not very well. I could get some words out."

After a CT scan, the medical team decided that Gibson was likely having an optic migraine. The next morning, when she still wasn’t feeling right, the neurologist ordered another scan with contrast — and that time, the stroke finally showed up.

"They could see that there was a blockage on the left side of my brain, and I was actively having a stroke," she said. 

Gibson was immediately airlifted to another hospital, where she had emergency brain surgery to remove the blood clot. 

"There was obviously a risk of death — if we didn't move fast enough, the time frame would be over," she said.

HIGH BLOOD PRESSURE A CONCERN WORLDWIDE, LEADING TO DEATH, STROKE, HEART ATTACK: HOW TO STOP A 'SILENT KILLER'

As she was flown to the hospital, Gibson said she felt certain she was going to die and would never again see her husband or her daughters, who were just 8 and 4 at the time.

"I thought I’d never get to see my children grow up and get married, or that I’d have to live in some kind of vegetative state and would never work again."

"I was thinking, ‘Did I tell my girls enough times that Mommy loves them? Does my husband know how proud I am of him?’"

The next thing she knew, Gibson was waking up from surgery in the ICU — and facing a long road to recovery.

"At first, I couldn't speak at all. I couldn't move my right side. I was trapped in my head — I could see what was happening and hear people asking me questions, but I couldn't answer."

Over the next few days, Gibson said her capabilities slowly started coming back. 

She received speech therapy, occupational therapy and physical therapy — and over time began to regain movement on her right side. 

REPORTS REVEAL THE RISK FOR STROKES IS ON THE RISE IN YOUNG ADULTS

Her first "assignment" was to tell her daughters that she loved them and that "Mommy’s going to be OK."

After a couple of weeks, Gibson returned home and continued with outpatient therapy for three hours a day, three days a week for a four-month period.

"It was during the first six weeks that we saw the quickest improvement, and then after that, it was slower and slower," she said.

"I had to relearn everything. And now, by the grace of God, I can do all the things."

Today, Gibson is still completely numb on the entire right side of her body. She also still sometimes struggles with finding the right words while speaking, she said, especially when she’s tired or stressed.

"But if you saw me, I look like a normal person," she said.

And in a full-circle moment, Gibson was finally able to complete the half-marathon last October.

Dr. Annie Tsui, chief of neurology at Access TeleCare, who is based in Texas, emphasized the prevalence of strokes among women and urged awareness.

"Strokes can occur for various reasons across different age groups and genders," Tsui, who was not involved in Gibson’s care, told Fox News Digital. "Even though strokes can occur at any age, women between the ages of 20 and 39 are at twice the risk compared to men."

While the primary risk factors for stroke are high blood pressure, high cholesterol, heart disease, obesity and diabetes, the causes for strokes in younger age groups differ from those typically associated with older people, Tsui noted. 

Those may include cardiac issues, blood clotting disorders, genetic predispositions, vascular abnormalities or trauma.

"Although no one is completely immune to the risk of stroke, individuals at higher risk should work with their doctor to develop a prevention plan," Tsui advised. "In general, maintaining a healthy lifestyle is crucial, as up to 80% of strokes can be prevented."

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It's crucial to be aware of the symptoms to receive treatment as quickly as possible, according to Tsui.

She recommends using the FAST acronym, shown below, as a convenient tool for identifying stroke indicators. 

"The chances of survival and positive outcomes are highest when the patient receives prompt medical attention," Tsui told Fox News Digital. 

Some stroke treatments are only effective if administered within three hours of when symptoms begin, she warned — with the risk of permanent brain damage or death rising with each passing minute.

"It's important to be vigilant in recognizing stroke symptoms and to seek medical assistance immediately at the first sign," Tsui said. 

"Every second counts in reducing the risk of brain injury, permanent disability or even death."

For more Health articles, visit www.foxnews.com/health.

10 months 3 weeks ago

Health, stroke, womens-health, health-care, lifestyle, family, parenting, medical-tech

KFF Health News

Tennessee Gives This Hospital Monopoly an A Grade — Even When It Reports Failure

A Tennessee agency that is supposed to hold accountable and grade the nation’s largest state-sanctioned hospital monopoly awards full credit on dozens of quality-of-care measurements as long as it reports any value — regardless of how its hospitals actually perform.

Ballad Health, a 20-hospital system in northeast Tennessee and southwest Virginia, has received A grades and an annual stamp of approval from the Tennessee Department of Health. This has occurred as Ballad hospitals consistently fall short of performance targets established by the state, according to health department documents.

Because the state’s scoring rubric largely ignores the hospitals’ performance, only 5% of Ballad’s final score is based on actual quality of care, and Ballad has suffered no penalty for failing to meet the state’s goals in about 50 areas — including surgery complications, emergency room speed, and patient satisfaction.

“It doesn’t make any sense,” said Ron Allgood, 75, of Kingsport, Tennessee, who said he had a heart attack in a Ballad ER in 2022 after waiting for three hours with chest pains. “It seems that nobody listens to the patients.”

Ballad Health was created six years ago after Tennessee and Virginia lawmakers waived federal anti-monopoly laws so two competing hospital companies could merge. The monopoly agreement established two quality measures to compare Ballad’s care against the state’s baseline expectations: about 17 “target” measures, on which hospitals are expected to improve and their performance factors into their grade; and more than 50 “monitoring” measures, which Ballad must report, but how the hospitals perform on them is not factored into Ballad’s grade.

Ballad has failed to meet the baseline values on 75% or more of all quality measures in recent years — and some are not even close — according to reports the company has submitted to the health department.

Since the merger, Ballad has become the only option for hospital care for most of about 1.1 million residents in a 29-county region at the nexus of Tennessee, Virginia, Kentucky, and North Carolina. Critics are vocal. Protesters rallied outside a Ballad hospital for months. For years, longtime residents like Allgood have alleged Ballad’s leadership has diminished the hospitals they’ve relied on their entire lives.

“It’s a shadow of the hospital we used to have,” Allgood said.

And yet, every year since the merger, the Tennessee health department has reported that the benefits of the hospital merger outweigh the risks of a monopoly, and that Ballad “continues to provide a Public Advantage.” Tennessee has also given Ballad an A grade in every year but two, when the scoring system was suspended due to the covid-19 pandemic and no grade issued.

The department’s latest report, released this month, awarded Ballad 93.6 of 100 possible points, including 15 points just for reporting the monitoring measures. If Tennessee rescored Ballad based on its performance, its score would drop from 93.6 to about 79.7, based on the scoring rubric described in health department documents. Tennessee considers scores of 85 or higher to be “satisfactory,” the documents state.

Larry Fitzgerald, who monitored Ballad for the Tennessee government before retiring this year, said it was obvious the state’s scoring rubric should be changed.

Fitzgerald likened Ballad to a student getting 15 free points on a test for writing any answer.

“Do I think Ballad should be required to show improvement on those measures? Yes, absolutely,” Fitzgerald said. “I think any human being you spoke with would give the same answer.”

Ballad Health declined to comment. Tennessee Department of Health spokesperson Dean Flener declined an interview request and directed all questions about Ballad to the Tennessee Attorney General’s Office, which also has a role in regulating the monopoly. Amy Wilhite, a spokesperson for the AG’s office, directed those questions back to the health department and provided documents showing it is the agency responsible for how Ballad is scored.

The Virginia Department of Health, which is also supposed to perform “active supervision” of Ballad as part of the monopoly agreement, has fallen several years behind schedule. Its most recent assessment of the company was for fiscal year 2020, when it found that the benefits of the monopoly “outweigh the disadvantages.” Erik Bodin, a Virginia official who oversees the agreement, said more recent reports are not yet ready to be released.

Ballad Health was formed in 2018 after state officials approved the nation’s biggest so-called Certificate of Public Advantage, or COPA, agreement, allowing a merger of the Tri-Cities region’s only two hospital systems — Mountain States Health Alliance and Wellmont Health System. Nationwide, COPAs have been used in about 10 hospital mergers over the past three decades, but none has involved as many hospitals as Ballad’s.

The Federal Trade Commission has warned that hospital monopolies lead to increased prices and decreased quality of care. To offset the perils of Ballad’s monopoly, officials required the new company to agree to more robust regulation by state health officials and a long list of special conditions, including the state’s quality-of-care measurements.

Ballad failed to meet the baseline on about 80% of those quality measures from July 2021 to June 2022, according to a report the company submitted to the health department. The following year, Ballad fell short on about 75% of the quality measures, and some got dramatically worse, another company report shows.

For example, the median time Ballad patients spend in the ER before being admitted to the hospital has risen each year and is now nearly 11 hours, according to the latest Ballad report. That’s more than three times what it was when the monopoly began, and more than 2.5 times the state baseline.

And yet Ballad’s grade is not lowered by the lack of speed in its ERs.

Fitzgerald, Tennessee’s former Ballad monitor, who previously served as an executive in the University of Virginia Health System, said a hospital company with competitors would have more reason than Ballad to improve its ER speeds.

“When I was at UVA, we monitored this stuff passionately because — and I think this is the key point here — we had competition,” Fitzgerald said. “And if we didn’t score well, the competition took advantage.”

Midwest correspondent Samantha Liss contributed to this report.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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This story can be republished for free (details).

10 months 3 weeks ago

Health Industry, States, Hospitals, Kentucky, North Carolina, Tennessee, Virginia

Health

The Caribbean Medical Professionals’ Summit set to catapult attendees’ careers

WITH LESS than one week to go until the inaugural Caribbean Medical Professionals’ Summit (CAMPS), the medical fraternity in Jamaica and the region is gearing up for an insightful weekend. On May 31 to June 2, medical professionals and aspirants...

WITH LESS than one week to go until the inaugural Caribbean Medical Professionals’ Summit (CAMPS), the medical fraternity in Jamaica and the region is gearing up for an insightful weekend. On May 31 to June 2, medical professionals and aspirants...

10 months 3 weeks ago

Health

Two main causes of skin cancer

SKIN CANCER develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms and hands, and on the legs in women. But it can also form on areas that rarely see the light of day, including your palms, beneath...

SKIN CANCER develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms and hands, and on the legs in women. But it can also form on areas that rarely see the light of day, including your palms, beneath...

10 months 3 weeks ago

PAHO/WHO | Pan American Health Organization

Ministers and high-level health authorities of the Americas discuss future pandemic response

Ministers and high-level health authorities of the Americas discuss future pandemic response

Cristina Mitchell

28 May 2024

Ministers and high-level health authorities of the Americas discuss future pandemic response

Cristina Mitchell

28 May 2024

10 months 3 weeks ago

PAHO/WHO | Pan American Health Organization

OPS llama a abordar las inequidades en el acceso a la salud sexual y reproductiva

PAHO calls for addressing inequities in access to sexual and reproductive health care

Cristina Mitchell

28 May 2024

PAHO calls for addressing inequities in access to sexual and reproductive health care

Cristina Mitchell

28 May 2024

10 months 3 weeks ago

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