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Morning Briefing

Summaries of health policy coverage from major news organizations

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Thursday, Jan 31 2019

Full Issue

Viewpoints: Lessons On A.I. And Health Disparities; #ThisIsOurLane Response Continues To Expand With Medical Community

Opinion writers focus on these health care issues and others.

There are many questions about whether A.I. actually works in medicine, and where it works: can it pick up pneumonia, detect cancer, predict death? But those questions focus on the technical, not the ethical. And in a health system riddled with inequity, we have to ask: Could the use of A.I. in medicine worsen health disparities? There are at least three reasons to believe it might. (Dhruv Khullar, 1/31)

On November 6, 2018, in response to a position paper on firearm injuries and death from the American College of Physicians, the National Rifle Association (NRA) fired off a tweet admonishing 鈥渟elf-important anti-gun doctors to stay in their lane.鈥 Physicians 鈥 many of whom are also gun owners 鈥 quickly responded that the topics of gun violence and firearm-injury prevention are squarely within our lane. Then, less than 12 hours after the NRA tweet, another mass shooting took place, in Thousand Oaks, California. On November 7 and 8, the Twitter hashtag #ThisIsOurLane went viral. (Megan L. Ranney, Marian E. Betz, and Cedric Dark, 1/31)

A quiet but revolutionary new national health policy goes into effect this week, ushering in changes that could lead to important medical discoveries that benefit most Americans. There鈥檚 just one problem. Implementing the change will require that our country鈥檚 health researchers make some fundamental changes in how they do business. Under the National Institutes of Health鈥檚 new Inclusion Across the Lifespan policy, federally supported medical research must include patients of all relevant ages or explain their exclusion. Since most studies already include adults, and a mandate to include children has existed since 1998, the novelty in this policy is the stipulation that clinical research include people age 65 and older. (Louise Aronson, 1/31)

I鈥檓 grateful that two courts have recognized the right of transgender students like Aidan to use the bathrooms and locker rooms that match their gender identity. But now the other students have asked the Supreme Court to review the case.聽We are working with the聽American Civil Liberties Union to discourage the Supreme Court from taking up the case.聽It might seem like this is just about a bathroom 鈥 but in fact it鈥檚 a powerful institution saying to a child, you have no right to be who you say you are. Schools form the center of kids鈥 social lives, and they are where kids develop a sense of themselves. Had the school excluded Aidan from the same facilities as other boys, it would have negated, instead of affirmed, his new and shining confidence and ease in the world. (Melissa DeStefano, 1/30)

We don鈥檛 suggest that all women should take hormones, or will benefit if they do. We are well aware that every medication carries risks. Neither of us has financial ties to the pharmaceutical industry. We simply are persuaded that the minor risks of HRT for some women are far outweighed by the major benefits for most women. (Avrum Bluming and Carol Tavris, 1/31)

On January 14, Trump administration rules that would broadly allow employers to deny contraceptive coverage to their employees on the basis of religious or moral objections were temporarily blocked by a federal court. But the legal battle is likely to continue. (Cynthia H. Chuang and Carol S. Weisman, 1/31)

A new study indicates a steep climb in benzodiazepine prescriptions in the U.S. Between 2003 and 2015, primary care physicians鈥 prescribing of benzodiazepines doubled. As a psychologist, who was funded a decade ago by the National Institute of Mental Health to study benzodiazepine prescriptions, I don鈥檛 find these new statistics surprising. Our health care system has some serious cracks, but solutions exist.Benzodiazepines (sometimes called 鈥渂enzos鈥) work to calm or sedate a person. Common benzodiazepines include Valium, Xanax and Klonopin, among others. Without a doubt, these medications are effective. They work, which is partly why physicians keep prescribing them and patients keep taking them. But, the potential negative side effects and toxicity of benzodiazepines are well-established. (Joan Cook, 1/30)

For a substantial minority of older adults, a stay in a post-acute care facility is the gateway into a cycle between the hospital and the nursing home that spans the final months of life. Certain Medicare and Medicaid policies perpetuate this cycle. (Lynn A. Flint, Daniel J. David, and Alexander K. Smith, 1/31)

Baker proposes to experiment with the state鈥檚 Medicaid program, which serves our most vulnerable residents, by attempting to use strong-arm tactics to compel so-called voluntary reductions from drug manufacturers, not unlike what President Trump has touted. This is a dangerous game, with Massachusetts鈥檚 neediest residents as the potential big losers. (Robert K. Coughlin, 1/30)

A recent analysis by the Natural Resources Defense Council, Little Village Environmental Justice Organization, Southeast Environmental Task Force and other community groups examined the cumulative impact of environmental health hazards facing different Chicago neighborhoods. It looked at things like toxic air pollution (think diesel emissions), lead exposure and locations of hazardous waste sites. It also evaluated factors that make places more vulnerable to harm, such as the number of very young people, poverty and race. The study found that Chicago has uneven and inequitable exposure to pollution and toxins across its neighborhoods. As a map shows, Chicago has concentrated industry in low-income communities of color. Given the city鈥檚 racial history, this fact isn鈥檛 shocking. What鈥檚 distressing is that the city is still doing so. (Elizabeth Cisar, 1/30)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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