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08/24/2016

The Tyranny of Corporatized Health Care: Time for Single-Payer

by Craig Klugman, Ph.D.

In Illinois, Land of Lincoln insurance and Aetna announced that they are pulling out of the health insurance Marketplace. In other states, United HealthCare and Humana have announced pulling out of the exchanges. As a result, many newspaper headlines and political pundits have declared the Affordable Care Act (ACA, also known as Obamacare) to be in a “death spiral.”

Such statements are undermined by the latest studies showing the ACA is working. The Kaiser Family Foundation reported that three-quarters of people who lacked insurance before the ACA now have it. RAND Corp found that more people are receiving medical treatment and getting needed prescriptions as a result of the ACA.…

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This entry was posted in Featured Posts, Health Care, Health Policy & Insurance and tagged , , , . Posted by Craig Klugman. Bookmark the permalink.

08/24/2016

Jailing for Dollars: The Federal Government Takes Steps to Eliminate a Moral Stain on Justice in the US

The United States has become the world’s leading jailer with 2.2 million people in jails and prisons across the country.  With a combination of government and privately run facilities, the nation faces the moral issues surrounding the prison-industrial complex.  As … Continue reading

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08/24/2016

The Relentless Rise of Healthcare Expenditures

Need I say more? The post The Relentless Rise of Healthcare Expenditures appeared first on PeterUbel.com.

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This entry was posted in Health Care and tagged , , , . Posted by Peter Ubel. Bookmark the permalink.

08/23/2016

Patient, Family, and Clinician Experiences with Voluntarily Stopping Eating And Drinking (VSED)

A symposium that I edited is coming out shortly from Johns Hopkins University Press:  "Patient, Family, and Clinician Experiences with Voluntarily Stopping Eating And Drinking (VSED)." The symposium includes 15 personal narratives from those invo...

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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

08/22/2016

Finally increasing postdoc pay. But what about the biomedical workforce?

Postdocs in the U.S. have been earning around $40,000 for the longest time. Postdoctoral fellows and graduate students constitute the bulk of the academic biomedical research workforce. In May of this year, a new regulation on overtime pay was proposed by the U.S. Department of Labor which aimed to raise salaries (Benderley 2016). Because postdocs work more than 40 hours per week, the regulations, now approved, will raise stipends to $47,484 which is the rate for Ruth L. Kirschstein National Research Service Awards (NRSAs) but serves as the standard for stipends used by most institutions (Kuo 2016). Institutions are obligated to either raise the pay or can put in punch card systems (track their pay somehow) and pay postdocs overtime. This overall 9% increase will not be seen right away. According to the new rule, the first two years of a fellow’s salary will be significantly lower (just 0.8% increase), but at the third year, the increase would be 4% (Kuo 2016). There are more caveats. The new rule has exemptions for overtime pay and it does not apply to teachers including graduate student teaching assistants or tenured/non-tenured faculty. So those postdoc with teaching responsibilities may fall through the cracks at receiving this increase in pay. Postdocs heavily dependent on teaching, such as those in the social sciences and humanities will likely be unaffected by the stipend increase. Most commentators have been supportive of increasing postdoctoral salaries. But the question that is on everyone’s mind is how will this increase impact the biomedical workforce?

 

Several who have chimed in on this debate have claimed that the pay hike will not significantly impact the current situation. Institutions have several months to begin implementation and this should be relatively straightforward. But will we see postdocs being dropped at the 3 year mark when stipends are dramatically meant to increase? Certainly some bean counters might try and utilize caveats in the rule to not pay postdocs a better salary because they are doing some side teaching or may decide to count their hours placing in time consuming time sheet systems. Also, postdocs may be pressured to finish up after their first couple years or perhaps fewer postdocs will be hired overall. But is this a bad thing? In a seminal paper by Bruce Alberts and several prominent biomedical scientists titled Rescuing US Biomedical Research From Its Systemic Flaws (among other key papers), the authors explain that the current biomedical science environment is unsustainable and in a state of hypercompetition where postdoctoral fellowships are becoming longer and researchers may undertake multiple postdocs (Alberts et al., 2014). Additionally, it is difficult to secure Principal Investigator (professorial-type) positions and the mean age of first time R01s (NIH’s flagship grant) has increased to about 42 years from 37 in the 1980s. I am positive that according to many, raising postdoc salaries means that less NIH dollars will go to research labor and decrease the workforce which is an overall drawback. But decreasing the overall workforce might be beneficial in that the competition for professorial positions might be reduced and grant success rates could increase. Because scientists have an ethical duty to promote entry of our youth into scientific professions, this should be done with a caveat in that students should know that a scientific profession might be a long and difficult road. And in many cases, this road might not lead to the ultimate position scientists desire: a research-based academic position with decent prospects at obtaining funding. Raising postdoctoral stipends, albeit in the right direction, is just one small step into making our biomedical science workforce in the U.S. sustainable. Greater efforts are required to make career prospects for future scientists reasonable.

 

References

 

Alberts, B., Kirshchner, M.C., Tilghman, S. and Varmus, H. 2014. Rescuing US biomedical research from its systemic flaws. Proceedings of the National Academy of Sciences (USA) 11(17):5773-77.

 

Benderly, B.L. 2016. Postdoc pay to increase due to new overtime rule. Science

 

http://www.sciencemag.org/careers/2016/05/postdoc-pay-increase-due-new-overtime-rule. Last updated: August 15, 2016.

 

Kuo, M. 2016. NIH sets new postdoc stipend levels. Science http://www.sciencemag.org/careers/2016/08/nih-sets-new-postdoc-stipend-levels. Last updated: August 15, 2016.

 

 

 

 

 

 

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This entry was posted in Health Care and tagged . Posted by Bioethics Today. Bookmark the permalink.

08/22/2016

Israel Stinson v. Children’s Hospital LA – the LASC Lawsuit

Israel Stinson was declared dead in early April 2016.  But his parents were able to continue organ support by obtaining court injunctions and stays in state and federal court.  They later transferred him to Guatemala.  He is now in Los Angeles.   

The Los Angeles Superior Court is now the 4th court to be involved in this case.  Previous rulings were issued by Placer County Superior Court, the U.S. District Court for the Eastern District of California, and the U.S. Court of Appeals for the Ninth Circuit.

On  Thursday, Israel's mother obtained an ex parte temporary restraining order against Children's Hospital LA.

An order to show cause re preliminary injunction is scheduled for September 9, 2016, at 9:30 a.m.   Any opposition is to be filed and served by Septem­ber 1, 2016, and any reply is to be filed and served by September 6, 2016.

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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

08/21/2016

Right before I Die – Photographic Exhibition

"Right before I Die" is a new photographic exhibition at the LA Museum of Tolerance.  The photographs show people facing serious illness along with the subject's words of wisdom and hope.  

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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

08/20/2016

Photo Series Captures Death and Dying in Palliative Care Unit

Western Sydney Local Health District multimedia manager Carlos Furtado recently had the privilege of photographing a day in Mt Druitt Hospital’s Supportive and Palliative Care Unit.  

With the consent of patients and families, Mr Furtado was given access to photograph the most intimate of moments when patients, families and staff were dealing head-on with the reality of dying and death.


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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.

08/19/2016

Owning Medical Professionalism

by Jon C. Tilburt, MD & Richard R. Sharp, PhD

Discontinuity, handoffs, and shiftwork have infiltrated the fabric of healthcare. These changes, made in the name of patient safety, may have the unintended effect of reducing residency training to little more than a terrible shift job, disconnected from the professional ethos so critical to the practice of medicine.

In their piece in AJOB this month Dubov and colleagues highlight several problems with resident duty hour restrictions. They postulate that cultivating a vocabulary of personal and professional “ownership” could counteract the detrimental effects of those restrictions. Their facility with the duty-hours literature is impressive and they rightly note how duty hour restrictions may have especially deleterious effects on surgical training.…

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08/19/2016

Hastening Death by Voluntarily Stopping Eating and Drinking: Clinical, Legal, Ethical, Religious and Family Perspectives

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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope, JD, PhD. Bookmark the permalink.