One Brainworm To Rule Them All

“RFK Jr. is not a scientifically literate, fact-based, competent, experienced, or measured person. He is wrong about HIV/AIDS; linking vaccines to autism; and the purported danger of thimerosal. On some things, he is correct: The COVID regime and the “noble lies”—which are still lies!—spread to the American public by our purported health authorities are despicable. We still need accountability. Considering which endocrine disruptors might exist in our environment and what unintended consequences might stem from SSRIs are valid research questions to which RFK Jr. has brought attention. Also, raw milk is great.
But in order to actually administer these programs, you need more than the ability to just ask questions and spread theories about what could be happening. You need some amount of competence. Perhaps RFK Jr. can take a pickax to the government waste that stems from certain companies being in bed with their overseers, but don’t count on it”

https://reason.com/2024/11/15/one-brainworm-to-rule-them-all/

Can RFK Jr. Fix Our Dysfunctional Public Health Agencies?

“The NIH is the world’s largest public funder of biomedical and public health research, with a budget of $47 billion, most of which is used to support research at universities and academic medical centers. The agency has long been criticized for being way too risk-averse when it comes to choosing which research projects to fund.”

“Being informed by the best information is certainly the right goal. But RFK Jr.’s long history of anti-vaccination agitation suggests he is not a source of the best information for the safety and efficacy of modern vaccines. This includes false assertions that vaccines cause autism; that they are not tested using placebo-controlled trials; and, contradicting the previous claim, that COVID-19 vaccines killed more people than did a placebo.
Again, the CDC needs fixing, but RFK Jr.’s skepticism about the safety and efficacy of modern vaccines would further undermine what should be the CDC’s main focus: the prevention of the spread of dangerous infectious diseases.”

“Four years into the post-COVID era, most research has found that ivermectin and hydroxychloroquine provide no treatment benefit for the infected. In April, the Journal of Infection published a report about a randomized controlled trial that concluded, “Ivermectin for COVID-19 is unlikely to provide clinically meaningful improvement in recovery, hospital admissions, or longer-term outcomes.””

“Giving drug development and infectious disease an eight-year break seems inadvisable. After all, the death rate for cancer has continued to drop from 2016 to today, partially as a result of lower incidence stemming from lifestyle changes, but also because of better and more widely available pharmaceutical treatments. Recent calculations show the value of medicines to patients far outweigh the profits the drug companies rake in. And, as ever, infectious diseases lurk in the background waiting for us to lower our guards or seeking just the right mutation to enable them to jump into the human population.”

“RFK Jr.’s solution to stemming the tide of chronic illnesses is better diets and physical fitness. History suggests government interventions will have little effect on either. After all, the federal government has been periodically issuing dietary guidelines since 1979 and promoting physical fitness since 1956. The Lancet authors agree with RFK Jr.’s aspirations but suggest in the meantime that “regulations need to be put in place to eliminate barriers to accessing new-generation obesity clinical treatments, ensuring the availability and affordability of these options to the broader population.””

“The FDA needs streamlining to speed biomedical innovation, the NIH needs greater risk-taking in research, and the CDC needs to be laser-focused on preventing infectious diseases. None of these appear to be high on the agenda of possible incoming secretary of health and human services.”

https://reason.com/2024/11/15/can-rfk-jr-fix-our-dysfunctional-public-health-agencies/

The Government Monopoly on Donated Kidneys Is Killing Americans

“An estimated 12 people die every day while waiting for a kidney transplant. At least some of those deaths are preventable, and monopoly government contractors shoulder most of the blame.
“Monopolies don’t work and 
government-funded monopolies are even worse,” says Jennifer Erickson, a former Obama White House staffer who now works as a senior fellow at the Federation of American Scientists.”

” All told, more than 17,000 kidneys (as well as thousands of other organs) are going to waste each year instead of finding their way to dialysis patients who need a replacement. That’s a tremendous opportunity cost. And because there’s no competition between OPOs, if you’re unlucky enough to need an organ and you live in an area where there’s a poor-performing OPO, you might never get one.”

https://reason.com/2024/09/30/against-government-kidney-monopolies/

Trump’s health care plan exposes the truth about his “populism”

“Vance’s sunny rhetoric here disguises his plan’s inegalitarian moral priorities.
It is true that the young and healthy have different medical needs than the old and sick. And before the Affordable Care Act’s regulations, the former could sometimes procure cheaper insurance tailored to their (currently) limited needs.

But this came at a social cost. Insurers were able to offer cheap health coverage to those who barely needed it by screening out those with preexisting conditions. In Vance’s terminology, they constructed low-risk pools: By only including people who were unlikely to require expensive treatments in their plans, they could profitably provide low-premium insurance to the young and well.

Meanwhile, sick and/or older Americans on the individual insurance market either went without coverage or were forced to pay dramatically higher premiums in order to cover the high cost of their care. Some state governments tried to defray this cost somewhat by subsidizing high-risk pools. But enrollees still paid much higher premiums than the typical market rate, and their coverage often excluded the treatments they needed most.

The Affordable Care Act effectively forced the healthy to subsidize the sick. It required insurers to include those with preexisting conditions in their plans and cover all medically necessary procedures. To guarantee that insurers could still turn a profit and that coverage remained (at least somewhat) affordable for all, the government provided consumers with insurance subsidies.

The upshot of all this was that coverage became a little more expensive for some healthy people, while growing much cheaper for the old and seriously ill.”

“Vance’s vision for health care policy helps clarify the character of the right’s burgeoning “populism.” On trade and immigration, Vance’s ideology may prize a nationalistic conception of the common good above free markets. But on most economic questions, its iconoclastic rhetoric belies its fealty to conservative orthodoxy — and thus, to “the ruling class” whom Vance loves to deride.

As Trump’s running mate, Vance is campaigning on tax cuts for corporations and the wealthy and deregulation for health insurers. The rest of Trump’s economic agenda is rather hazy. But if his first term is any guide, it would also involve curtailing workers’ collective bargaining rights, reducing workplace safety standards, and attempting to throw millions off of Medicaid. Vance has not seen fit to criticize any aspect of this record.”

“For Vance, deregulating insurance markets at the expense of the vulnerable is not neoliberal or anti-populist. But arguing that politicians should not spread incendiary lies about immigrants is.”

https://www.vox.com/politics/372635/trump-health-care-plan-vance-preexisting-conditions

Trump’s campaign against public health is back on

“People are already losing trust in vaccines: Only 40 percent of Americans believe it is extremely important for parents to get their children vaccinated, down from 64 percent in 2001. It is perhaps the most worrying trend in public health right now.
We have the tools to stop many infectious diseases — if we take advantage of them. Trump’s words are making it less likely that people will.”

“Meanwhile, measles cases in the US matched their 2023 total over just the first few months of 2024. A local outbreak in Oregon has seen nearly two dozen cases since June; at least two people have been hospitalized.

A disease that was once effectively eradicated in the US — and which school mandates helped to stamp out — is mounting a comeback.

Donald Trump could choose to wield his tremendous influence to try to restore people’s faith in vital public health measures. He did it, if half-heartedly, during the pandemic and it had the desired effect. Instead, he’s stoking doubts about the value of vaccines, and courting the dangers vaccine hesitancy brings.”

https://www.vox.com/today-explained-newsletter/366472/2024-election-donald-trump-vaccines-schools

Free medical school won’t solve the doctor shortage

“The US does have significantly fewer doctors per capita than some other wealthy nations, such as Germany and Sweden. But America’s physician-to-patient ratio is actually about the same as other developed countries — Canada, the United Kingdom, Japan, France — that still generally rank better on measures of health care quality than the US does. So aggregate numbers alone are not enough to explain the access problems that patients face, and experts disagree over whether we need to boost the overall supply of providers in the short term.
The bigger problem is misallocation in the US physician workforce, Coffman told me last year. We know that we don’t have enough doctors in certain important specialties: primary care, obstetrics, and psychiatry, for example. We also don’t have nearly enough providers in a broad swath of specialties practicing in rural and other low-income communities. Between 2010 and 2017, while large urban counties added 10 doctors per 100,000 people on average, rural counties lost three. As a result, metro regions had 125 doctors per 100,00 patients, while rural areas had 60.

America is littered with doctor deserts, areas where there are not enough primary care providers, much less specialists or hospital-level services. The federal government estimates that 80 percent of rural Americans live in medically underserved communities.

In the long term, the US will undoubtedly need more doctors in rural and urban areas alike. Groups like the Association of American Medical Colleges continue to project long-term workforce shortages, as boomer-generation doctors reach retirement age and the population of seniors requiring medical care swells.”

https://www.vox.com/future-perfect/361620/bloomberg-johns-hopkins-free-medical-school-doctor-shortage

We can make birth safer for Black mothers. Here’s how.

“Over the last 30 years, nearly every wealthy country in the world has made it much safer for people to have babies. Only one outlier has moved in the opposite direction: the United States, where the rate of people dying in childbirth continues, stubbornly and tragically, to rise. In 2021, 1,205 US women died from birth-related causes, up from 754 in 2019. Many of those deaths — a full 89 percent in one Georgia study — are potentially preventable with the proper care.”

https://www.vox.com/the-highlight/24092448/black-mothers-maternal-mortality-crisis-solutions