Perspectives: New Hospital Pricing Rules Provide Clarity; Abortion Opponents Want National Ban
Editorial pages weigh in on these public health topics.
New Federal Rules Could Improve Health Care Price Transparency
"Would you like Wednesday or Friday?” the medical scheduler asked. That simple question catches many people flat-footed. It’s easy to take it at face value, look at your calendar and determine which date you prefer for a needed surgery. In my case, it was an arthroscopic surgery for a torn meniscus — one of the pieces of cartilage in the knee that, when damaged, can cause significant pain and swelling. But there are consequences to selecting a surgery date that go beyond the block of time on your calendar. For me, there was about $11,000 hanging in the balance. That’s because behind the question of Wednesday or Friday was the issue of where the surgery would take place. On Wednesdays my orthopedic surgeon practiced at his affiliated hospital. On Fridays he performed procedures at the outpatient surgery center located literally across the street. The cost for his work was about the same at both locations, but the facility fees at the hospital led to a price tag that was about $11,000 higher than the cost for the same procedure, with the same doctor, at the outpatient location across the street. (Michael S. O'Neil, 4/4)
The New York Times:
The Authoritarian Plan For A National Abortion Ban
The anti-abortion movement was never going to stop with overturning Roe v. Wade. For years, Republicans have argued that their goal was to return the issue of abortion to the states. At no point was this believable; since 1984, the Republican Party platform has called for a constitutional amendment banning abortion. Having spent decades denouncing abortion as a singular moral evil, the anti-abortion movement will not be content to return to a pre-Roe status quo, where abortion was legal in some places but not others. (Michelle Goldberg, 4/5)
The Role Of Mandated Nurse Staffing Ratios
The pandemic put a spotlight on healthcare staffing challenges, especially in nursing. California is still the only state to mandate minimum nurse/patient ratios. Are minimum nurse staffing ratios an effective way to ensure quality care and patient safety in hospitals? (Bonnie Castillo and John Welton, 4/6)
Excited Delirium: Valid Clinical Diagnosis Or Medicalized Racism?
The “diagnosis” of excited delirium, a term often used to justify and defend police brutality, disproportionately against Black people, has circulated in the medical canon for more than 25 years. It is time — past time, actually — for organized medicine to denounce its diagnostic validity and its use as a shield to justify excessive police force. It reemerged most recently on May 25, 2020, when Minneapolis police officer Derek Chauvin killed George Floyd, an unarmed Black man, by kneeling on his neck for more than nine minutes. During that time, fellow officer Thomas Lane was heard to say, “I am worried about excited delirium or whatever.” (Jennifer K. Brody, Ayana Jordan, and Sarah E. Wakeman, 4/6)
The Washington Post:
The Health-Care Industry Doesn’t Want To Talk About This Single Word
When I write about health policy or speak with medical colleagues about barriers to care, there is one word — and one word only — that evokes a wide range of responses. Some respond with silence; others with avoidance. Some respond with anger and defensiveness. The word appeared at the top of a paper I submitted to the Journal of the American Medical Association in 2015 with David R. Williams, a professor of public health and African American studies at Harvard University. The title: “Racism in Health and Healthcare: Challenges and Opportunities.” (Ron Wyatt, 4/5)
We Must Enhance--But Also Decolonize--America's Global Health Diplomacy
COVID-19 continues to wreak havoc across the world, accounting for more than 2.7 million deaths so far; prolonged economic shutdowns; and the dismantlement of global health systems. In no small part, this is due to failures of governance and intentional health policy choices. Despite the swift and unprecedented development of multiple COVID-19 vaccines, more than 66 percent of the countries around the world—predominantly in the Global South—have yet to receive a single vaccine dose. In comparison, 10 countries have received 75 percent of the global vaccine supply. These appalling statistics represent the outcomes of contemporary neocolonial approaches—policies, programs and global governance structures that continue to sustain the same power dynamics and outcomes as during colonization—towards the non-Western world. The Western world's inability to move past its colonial mentality continues to perpetuate structural violence and social inequities across the globe. COVID-19-related global health inequities, including in vaccine distribution, highlight our global health governance and programs' failures that uphold a Western commitment to the colonial status quo while relegating Black and brown people to collateral damage. ( Ans Irfan, Christopher Jackson, Ankita Arora, 4/5)