“Researchers at Harvard University and the University of California Berkeley examined what happened when Medicare beneficiaries faced an increase in their out-of-pocket costs for prescription drugs. They found that a 34 percent increase (a $10.40 increase per drug) led to a significant decrease in patients filling their prescriptions — and, eventually, a 33 percent increase in mortality.
The rise in deaths resulted from people indiscriminately cutting back on medications when they had to pay more for them, including drugs for heart disease, hypertension, asthma, and diabetes.
“We find that small increases in cost cause patients to cut back on drugs with large benefits, ultimately causing their death,” the authors — Amitabh Chandra, Evan Flack, and Ziad Obermeyer — wrote. “Cutbacks are widespread, but most striking are those seen in patients with the greatest treatable health risks, in whom they are likely to be particularly destructive.””
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“This finding challenges an important assumption embedded in American health care policy. In the 1970s and ’80s, the RAND Health Insurance Experiment concluded that small copays encouraged patients to use fewer health care services without leading to worse health outcomes. That helped establish a new economic argument for insurers to ask their customers to put more “skin in the game”: it would encourage more efficient use of health care services with no downside.
But that premise presumed people would be rational. For example, if they are being asked to pay more money for prescription drugs, they would cut back on less-valuable medications first. The Harvard/Cal study didn’t detect any such rationality. When costs went up, people just stopped filling their prescriptions for statins — high-value drugs that are effective in preventing heart attacks.
The researchers explained it like this: The way patients behaved when faced with higher out-of-pocket costs would suggest that they placed very little value on their lives. They literally stopped taking high-value drugs because of the price.”
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“If patients can’t make good value judgments, the economic argument for cost-sharing starts to crumble, and it starts to seem like eliminating cost-sharing — increasing the likelihood patients will continue to take the medications they need to stay alive — would be a cheap way to “buy” people more health. As the researchers wrote, “improving the design of prescription drug insurance offers policy makers the opportunity to purchase large gains in health at extremely low cost per life-year.””
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“Eliminating out-of-pocket costs would come with a price: Insurers would likely charge higher premiums to offset the loss of the copays and coinsurance that currently reduce their direct costs. But if the goal is better health outcomes, that is arguably a price worth paying.”
“While there is still some debate around the potential increase in drunk driving, there is a vast, peer-reviewed, scientific literature around the harms of secondhand smoke inhalation, and around the massive health benefits associated with the sharp decline in smoking in part due to smoke-free policies.
We know that smoking bans have been effective at reducing secondhand smoke exposure. Bans in restaurants, bars, and other hospitality establishments have the added benefit of ensuring that workers are not forced to carry the health costs against their will simply due to their place of employment. Bans have also been effective at reducing smoking and “reducing opportunities to smoke, changing smoking norms, and reducing smoking rates.”
Smoking and exposure to secondhand smoke increases the risk of cardiovascular disease, pulmonary disease, cancer, and death. Research has shown that heart attack admissions “rapidly declined” after the implementation of 100 percent smoke-free laws.
All of this to say that if there was in fact a small increase in fatal drunk driving accidents as a result of these bans, the bans were still worth it.”
“According to the BBC, a minimum of 350,000 illegal abortions occur annually in Argentina, a figure that some activist groups feel is undercounting the real number. Illegal abortions can lead to health complications and even death for the people who experience them — the World Health Organization estimates that up to 13.2 percent of maternal deaths worldwide can be attributed to unsafe abortions.
Argentina has seen adherence to Catholicism decline in recent years, according to a study from the National Scientific and Technical Research Council (CONICET). The Buenos Aires Times reports that in 2019, 62.9 percent of the population identified as Catholic, a 13.6 percentage point drop since 2008. Simultaneously, while evangelicals gained new adherents, the share of people identifying with no religion grew the most, reaching nearly 20 percent of the population.”
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“While Argentina is still a largely Catholic country, this decline could explain why Pope Francis’s comments opposing legalizing abortion did not have an overwhelming effect on the outcome of this vote. Francis, who was born and worked in Argentina for much of his life, has referred to abortion as being part of a “throwaway culture” and has rooted his opposition to the medical procedure as being based in science, according to Crux, a Catholic online newspaper.
According to France 24, Catholics weren’t alone in opposing the measure; they joined forces with the country’s growing evangelical wing to mobilize against abortion. They will likely fight to overturn this measure, especially as this change exposes Argentina’s religious fault lines.
But the victorious activists are the abortion rights feminists who have spent years fighting for abortion legalization.”
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“Argentina became the biggest country in Latin America to legalize elective abortion”
“Again and again over the last four years, the Trump administration has made it harder for Americans — and people abroad — to get basic reproductive health care.
In 2017, the administration reimposed and broadened a rule, sometimes called the Mexico City policy, barring health organizations around the world that get US aid from providing or even discussing abortions. The result was a reduction in access to abortion, as well as services like contraception and prenatal care.
The same year, Trump’s Health and Human Services Department issued rules weakening an Obama-era mandate requiring employers to offer insurance that covers birth control, allowing them to claim an exemption if they had a religious or moral objection. Those rules have been tied up by lawsuits, but just won a major victory at the Supreme Court in July.
And in 2019, the Trump administration finalized what reproductive health advocates call a “domestic gag rule,” barring health care providers that get federal family planning funds under the Title X program from performing or referring for abortions. As a result, hundreds of clinics have exited the program, cutting its ability to provide birth control services in half.
These actions have had a real and serious impact on patients, only compounded by a pandemic that has made it even harder for many Americans, especially low-income people of color, to access reproductive health care.
But there is likely an end in sight for many of the Trump administration’s policies: Since they were enacted by executive action, they can be undone by President-elect Joe Biden when he takes office, without any help from Congress.
“The whole “airborne” debate can get very complicated and technical, but the basic issue is simple: Indoor dining is very unsafe. And the outdoor dining that’s been used as a substitute is running out of steam as weather gets cooler across much of the country. For health reasons, we need fewer customers at these businesses. For economic reasons, we need them to survive. The fix is a huge bailout.”
What’s Wrong with Employer Sponsored Health Insurance Ed Dolan. 11 6 2018. Niskanen Center. The Real Reason the U.S. Has Employer-Sponsored Health Insurance Aaron E. Carroll. 9 5 2017. New York Times. Column: The health insurance tax exemption makes care more affordable,
“The single largest tax expenditure in the United States is for employer-based health insurance. It’s even more than the mortgage interest deduction. In 2017, this exclusion cost the federal government about $260 billion in lost income and payroll taxes. This is significantly more than the cost of the Affordable Care Act each year.”
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“Let’s take a hypothetical married pediatrician with a couple of children living in Indiana who makes $125,000 (which is below average). Let’s also assume his family insurance plan costs $15,000 (which is below average as well).
The tax break the family would get for insurance is worth over $6,200. That’s far more than a similar-earning family would get in terms of a subsidy on the exchanges. The tax break alone could fund about two people on Medicaid. Moreover, the more one makes, the more one saves at the expense of more spending by the government. The less one makes, the less of a benefit one receives.
The system also induces people to spend more money on health insurance than other things, most likely increasing overall health care spending. This includes less employer spending on wages, and as health insurance premiums have increased sharply in the last 15 years or so, wages have been rather flat. Many economists believe that employer-sponsored health insurance is hurting Americans’ paychecks.
There are other countries with private insurance systems, but none that rely so heavily on employer-sponsored insurance. There are almost no economists I can think of who wouldn’t favor decoupling insurance from employment.”
“In 2011, a Congress member from Indiana helped pass federal legislation to strip funding from Planned Parenthood.
Two years later, the last Planned Parenthood affiliate in Scott County, Indiana, closed its doors because of budget cuts. It was also the last HIV testing center in the county. By 2015, an HIV outbreak was brewing in the state. At the peak of the outbreak, 20 new cases were being diagnosed per week, with a total of nearly 200 cases eventually reported, according to HuffPost.
But that Congress member, who became Indiana’s governor, didn’t want to authorize a needle-exchange program to stop the spread of the virus.
“I don’t believe effective anti-drug policy involves handing out drug paraphernalia,” he said.
That Indiana governor was, of course, Mike Pence. Now he’s the vice president, and on Wednesday, President Trump put him in charge of fighting coronavirus in the US.”
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“In general, the administration has sought to restrict funding to Planned Parenthood and other groups, reproductive health advocates say, without regard to the public health implications. The administration’s policies have already made it harder for low-income Americans to get screening for conditions like breast and cervical cancer. And some fear that, especially with Pence in charge, the administration could put politics over science when it comes to coronavirus response too.”
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“Finally, over two months after the HIV outbreak was reported, Pence said he would pray on the issue, according to the New York Times. Two days later, he issued an executive order for syringes to be distributed in Scott County.
The distribution helped stop the epidemic, according to the Times. But Pence didn’t actually allocate new money for the program, or for fighting the epidemic generally, forcing state officials to cut other health programs, Meyerson said: “overall, his governorship showed that he did not commit to an adequately funded public health infrastructure.””
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“Last year, the administration issued a rule barring Planned Parenthood and other groups that perform or refer for abortions from getting federal funding through Title X, a program aimed at providing family planning services to low-income Americans. As a result, nearly 1,000 health centers around the country have lost funding, making it harder for many Americans to get necessary services like cancer screening or HIV tests.”
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“Also in 2017, six members of the Presidential Advisory Council on HIV and AIDS resigned in protest, with one writing in Newsweek that “the Trump administration has no strategy to address the ongoing H.I.V./AIDS epidemic, seeks zero input from experts to formulate H.I.V. policy, and — most concerning — pushes legislation that will harm people living with H.I.V. and halt or reverse important gains made in the fight against this disease.”
Then, in 2019, the Trump administration cut funding for fetal-tissue research, despite long-standing arguments by scientific and medical experts that such research is crucial for developing vaccines and treatments for diseases. Research into AIDS and other conditions has already suffered as a result, Carter said.”