» Health Policy & Insurance Where the World Finds Bioethics Wed, 25 Nov 2015 18:00:42 +0000 en-US hourly 1 Expanding Notions of Discrimination: Genetic Information & Competitive Sports Fri, 16 Oct 2015 20:30:38 +0000 by Craig Klugman, Ph.D.

During a periodic training on the university’s harassment policies today, I learned that my institution has added “genetic information” to the list of characteristics against which one cannot be discriminated. When one of my colleagues asked, “Do you have an example of that,” the presenter stumbled. After a few beats she said if someone had a gene for a disease but did not have any symptoms of that yet or an evident physical disability.

The policy change likely follows from the federal Genetic Information Nondiscrimination Act that protects some medical information.…

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The Democratic Debate on Health: Not Much Wed, 14 Oct 2015 06:48:44 +0000 by Craig Klugman, Ph.D.

Unlike in last month’s GOP debate, in the Democratic Presidential Candidate debate last night, health care issues were not a central factor. If you recall, the GOP debaters went round in circles about whether children should be vaccinated. In the DNC debate, health care issues were raised in a brief mention of Obamacare (i.e. “Affordable Care Act (ACA)) and in greater depth in discussing insurance coverage of undocumented individuals.

When talking about Obamacare, Bernie Sanders stated that he preferred universal health care coverage over the ACA’s private insurance approach.

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Planned Parenthood revises reimbursement policy after video uproar Tue, 13 Oct 2015 21:54:38 +0000 0 Exclusive – Transatlantic divide: how U.S. pays three times more for drugs Mon, 12 Oct 2015 19:52:33 +0000 0 Clinton to propose cap on out-of-pocket costs for some drugs Mon, 21 Sep 2015 22:36:06 +0000 0 Poverty may increase odds of repeat hospitalizations Wed, 16 Sep 2015 20:01:04 +0000 0 The Age of Contractualism in Bioethics? Mon, 14 Sep 2015 12:00:51 +0000 by J.S. Blumenthal-Barby, Ph.D.

Various ethical theories underlie approaches to resolving bioethical dilemmas. Consequentialist theories hold that the moral evaluation of an action is based solely upon the goodness or badness of its consequences for all of the relevant parties. Deontological theories, on the other hand, hold that the moral evaluation of an action is based at least in part upon its intrinsic nature and its resulting conformity to moral rules. Popular deontological theories utilized in bioethics include Kantianism, Natural Rights theory, or theories about Special Obligations (e.g., physician fiduciary duties).…

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U.S. Supreme Court upholds federal health care law Fri, 26 Jun 2015 17:47:57 +0000 0 The Government Has No Backup Plan If Court Rules Against Obamacare Fri, 19 Jun 2015 17:52:20 +0000 0 U.S. anti-legalization group urges more access to marijuana research Thu, 28 May 2015 15:15:44 +0000 0 U.S. says insurers must cover FDA-approved birth control methods Thu, 14 May 2015 19:39:37 +0000 0 Inhaler ban boosts costs for people with asthma Wed, 13 May 2015 19:37:55 +0000 0 Congress approves formula fixing Medicare doctors pay Thu, 16 Apr 2015 18:04:54 +0000 0 Kaci Hickox: Public Health and the Politics of Fear Wed, 01 Apr 2015 20:13:56 +0000 0 When Ideology Trumps: A Case for Evidence-Based Health Policies Fri, 20 Mar 2015 19:29:50 +0000 by Bela Fishbeyn

In this issue of The American Journal of Bioethics (AJOB), Adina Preda and Kristin Voigt (2015) investigate the relationship between health policies, social determinants of health, and health inequalities. There is much empirical work demonstrating the correlation between social determinants of health and health outcomes, which establishes a clear relationship between a person’s social and economic status and her health outcomes. What are defined as social determinants of health varies depending on institution or organization, but the World Health Organization (WHO) broadly explains social determinants of health as “the conditions in which people are born, grow, live, work and age” and further, that “these circumstances are shaped by the distribution of money, power and resources at global, national and local levels” (World Health Organization, Social Determinants of Health.…

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The Social Determinants of Health: Why Should We Care? Sun, 01 Mar 2015 19:40:41 +0000 0 When Ideology Trumps: A Case for Evidence-Based Health Policies Sun, 01 Mar 2015 19:16:25 +0000 0 Precision Medicine Has Imprecise Ethics Wed, 18 Feb 2015 06:59:03 +0000 by Craig Klugman, Ph.D.

How do physicians diagnose disease? First they go through a set of symptoms and then compile a list of differential diagnoses or what the underlying disease may be. Then the doctor performs tests to rule out some diagnoses and advance others. In essence, though, diseases are classified according to their affect on the body—their symptology. What if instead of by symptoms, diseases were classified by their molecular function? Instead of being diagnosed with Type II Diabetes one might be diagnosed by whether there is a death of beta cells (i.e.…

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The coming revolution in much cheaper life-saving drugs Wed, 28 Jan 2015 22:56:04 +0000 0 ACA Report Card: One Year of Obamacare and the Individual Insurance Mandate Fri, 23 Jan 2015 13:00:41 +0000 by Craig M. Klugman

The United States has passed a milestone, the first year of the Affordable Care Act’s insurance mandate. This is the requirement that all U.S. residents have health insurance whether through an employer, an organization, or via the insurance marketplaces. Opponents of the ACA (also known as “Obamacare”) feared that this act would destroy the country by decimating the economy, creating a federal government takeover of healthcare, forcing employers to drop coverage, workers quitting who no longer need their employer-based health insurance, and companies cutting workers to stay below minimum thresholds.…

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Fight threatens thousands of Californians’ health coverage Wed, 21 Jan 2015 00:16:01 +0000 0 Medicare proposes covering lung cancer scans for heavy smokers Mon, 10 Nov 2014 23:49:23 +0000 0 A Plan to Cut Costs and Crime: End Hurdle to Job After Prison Mon, 10 Nov 2014 19:35:02 +0000 0 Guatemala may weigh softer drug punishments in liberalization push Wed, 15 Oct 2014 20:45:42 +0000 0 Wal-Mart raises healthcare costs, cuts benefits for some part-timers Wed, 08 Oct 2014 18:14:47 +0000 0 HHS: Health law will lead to big drop in free hospital care Wed, 24 Sep 2014 20:50:10 +0000 0 A simple change? The IOM Report on “Dying in America” Thu, 18 Sep 2014 05:15:42 +0000 by Craig Klugman, Ph.D.

Say there was a simple change that could be made to the health care system that would reduce cost, reduce demand, increase patient’s quality of life and satisfaction, address the whole patient and not just the disease, improve care coordination, and increase patient autonomy. All of this is possible, but it requires addressing the problem that in America we do not die as we want to.

This week the Institute of Medicine released its latest report,  Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.…

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Health Reform Watch: Study finds fewer deaths after MA health reform Thu, 11 Sep 2014 18:54:17 +0000 0 Top U.S. health adviser wants end to partisan fighting over Obamacare Mon, 08 Sep 2014 22:47:02 +0000 0 Teen Cancer Survivor Needs New Teeth, Insurance Company Refuses to Pay Wed, 30 Jul 2014 21:14:42 +0000 0 Calif. Considers Bilingual Drug Labels Wed, 30 Jul 2014 21:10:18 +0000 0 Abuse of U.S. generic-drug rules costs billions -report Wed, 23 Jul 2014 22:21:18 +0000 0 Time to Divorce Health Insurance & Employment Thu, 10 Jul 2014 05:07:31 +0000 by Craig Klugman, Ph.D.

In my last blog, I talked about ideologically-backed corporate control of health care choices as a result of the U.S. Supreme Court’s Hobby Lobby decision. That piece has led to several conversations this past week, many of which have revolved around the question of how to fix the problem of employer theology limiting or curtailing choices, because nearly half of all people in the U.S. have health insurance through their employer.

The result of these conversations is a consensus that there are two health policy moves that can be made: Changing a law and changing a system.…

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NY insurer to pay up to $31 million for denied mental health claims Wed, 09 Jul 2014 18:05:02 +0000 0 U.S. Democrats aim to turn contraception into campaign drive Tue, 08 Jul 2014 21:15:24 +0000 0 Insured young cancer patients fare better, live longer: study Tue, 03 Jun 2014 00:04:20 +0000 0 House Committee Votes to Allow Schools to Opt Out of Nutritional Program Thu, 29 May 2014 19:51:32 +0000 0 Deaths fell after Massachusetts healthcare overhaul: study Mon, 05 May 2014 22:44:51 +0000 0 Panel Says No to Medicare Coverage for Lung Cancer Screening Thu, 01 May 2014 17:03:42 +0000 0 Senator Advances Bill To Pay Medicare Beneficiaries to Register Advance Directives Mon, 21 Apr 2014 20:56:52 +0000 by Craig Klugman, Ph.D.

U.S. Senators Tom Coburn (R-OK) along with Senators Christopher Coons (D-DE) and Richard Blumenthal (D-CT) introduced a bill to the U.S. Senate (S. 224) that would “encourage Medicare beneficiaries to voluntarily adopt advance directives guiding the medical care they receive.”  The regulations for this bill are to be created by a broad group of stakeholders.

Specifically, the bill would:

(a) Establish an Advance Directive Certification Program
(b) Accredit vendors of online and written stored advance directives
(c)  Provide an incentive for completing an advance directive.…

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My Neighborhood Makes It Easier to Get Pregnant Than To Go To College Thu, 20 Mar 2014 17:43:01 +0000 0 Unusual Iowa abortion rule has surprising result Fri, 21 Feb 2014 19:40:29 +0000 0 Insured patients are often not transferred for better care, study finds Thu, 20 Feb 2014 22:45:32 +0000 0 Freedom for the corporation, religious servitude for the individual Tue, 18 Feb 2014 07:16:49 +0000 by Craig Klugman, Ph.D.

Many women in this country gained insurance coverage for their contraceptive costs under the controversial Affordable Care Act (ACA). One of the many challenges that have been levied against this law is the so-called contraceptive mandate, a requirement that all employer-sponsored plans cover the costs of contraceptives.

When it was announced, this mandate caused uproar from religious communities that believe contraception is immoral. In response, the Obama Administration altered the ACA to exempt health plans sponsored by religious employers, mostly houses of worship, from using their funds to pay for contraception.…

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Did AOL CEO Tim Armstrong Violate HIPAA? Wed, 12 Feb 2014 00:38:02 +0000 0 New rule allows patients to get test results directly from labs, without doctors’ clearance Wed, 05 Feb 2014 23:30:56 +0000 0 Obama: Marijuana No More Dangerous Than Alcohol Tue, 21 Jan 2014 18:01:30 +0000 0 The Year in Bioethics That Was Wed, 01 Jan 2014 21:05:33 +0000 by Craig Klugman, Ph.D.

Happy New Year. The ending of one year and the beginning of another is often a time for reflection, for reviewing the year that has passed and for making plans/predictions for the year to come. 2013 was the first full year of the re-launch of the editor’s blog as well.

Ten bloggers in addition to myself worked for us this year and we are thankful for their contributions: Maurice Bernstein, Arthur Caplan, Jennifer Chevinsky, Nanette Elster, Ellen Fox, Jessica Jerome, David Magnus, Steven Miles, Kayhan Parsi, and Thaddeus Pope.…

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A Call to Physicians: To Do No Further Harm, or Ethical Practice as Just Distribution of Healthcare Thu, 19 Dec 2013 22:40:25 +0000 Bandy X. Lee, M.D.

*Primum non nocere*, to first do no harm, is the unchanging foundation for Hippocratic medical ethics. Each generation must, nevertheless, redefine what “doing no harm” means for its time. As we are making historic transitions in healthcare in the U.S., now is such a time for our generation.

“Doing no harm” means first avoiding doing the most extreme harm—that is, violence. Meanwhile, it is important to note that our understanding of what constitutes violence has also been expanding: the multi-determined nature of violence, no matter the scale, point to causal dynamics beyond the immediately apparent.…

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FDA Finally Imposes Some Controls on Agricultural Antibiotics. Sort Of. Thu, 12 Dec 2013 00:13:01 +0000 0