KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Viewpoints: Beating Sepsis; Gaps In Life Expectancy; Using Big Data

A selection of opinions on health care from around the country.

STAT: How One Hospital Is Beating Sepsis And Saving Lives
When it comes to under-the-radar killers, sepsis is at or near the top of the list. It can begin quietly, often looking like the flu, pneumonia, or a urinary tract infection. And then it escalates, quickly erupting into widespread infection and inflammation that can cause organ failure and death if not treated fast enough. ... When we took a close look at it in 2014, we were very troubled to learn that nearly half of the patients who came to Dartmouth-Hitchcock with sepsis, or who developed sepsis in our hospital, died; the national average is between 35 percent and 60 percent. ... I called together clinicians and other experts from various parts of the medical center and said we needed to fix deaths from sepsis ASAP .... we did just that — our death rate from sepsis dropped by more than 75 percent. The solution wasn’t fancy. (James Weinstein, 2/22)

Los Angeles Times: The Growing Life-Expectancy Gap Between Rich And Poor
Researchers have long known that the rich live longer than the poor. Evidence now suggests that the life expectancy gap is increasing, at least here the United States, which raises troubling questions about the fairness of current efforts to protect Social Security. ... For example, we estimated that a woman who turned 50 in 1970 and whose mid-career income placed her in the bottom one-tenth of earners had a life expectancy of about 80.4. A woman born in the same year but with income in the top tenth of earners had a life expectancy of 84.1. The gap in life expectancy was about 3½ years. For women who reached age 50 two decades later, in 1990, we found no improvement at all in the life expectancy of low earners. (Gary Burtless, 2/22)

The New York Times' The Upshot: How To Make The Most Of Drugs We Already Have
Though you may not have realized it, there’s a good chance that a doctor has prescribed you a medication for a use other than what it was approved for. This off-label use is perfectly legal, but isn’t as safe as it might be, in part because incentives to invest in costly clinical trials to test such uses are weak. One out of five prescriptions is off-label. Some drugs, like those for cardiac conditions and anticonvulsants, are used off-label at a much higher rate. One study found that an average drug is used for 18 different conditions. (Austin Frakt, 2/22)

The Wall Street Journal: The Big-Data Future Has Arrived
Big data, the tech story of a few years ago, is now beginning to show big results. ... Already, thanks to big data, we have learned that toddlers learn language not from repetition—which we’ve thought for centuries—but by hearing words used in multiple contexts. We’ve also found that premature babies are at greatest risk when their heartbeats are stable (healthy baby hearts are more erratic). Researchers are making inroads into understanding the external influences on autism (carbon-dioxide levels, room temperature) and how urban crime can largely be isolated to just a few blocks, even individual buildings. ... We can now identify impending bouts of depression, even suicidal tendencies, by looking at the changing lifestyle (social media usage, diminishing movement) of potential victims. (Michael S. Malone, 2/22)

The Hill: An Obesity Penalty Would Be Legalized Discrimination
A study published earlier this month in the International Journal of Obesity has found that our common wisdom about the relationship between obesity and the risk for cardiovascular disease is possibly overstated. The U.S. Equal Employment Opportunity Commission (EEOC) has been considering rules that would, in effect, allow health insurers to charge obese people more for coverage if they fail to lose weight. This recent study strengthens the argument against the obesity penalty. ... Penalizing the obese for a medical condition and charging them more for medical coverage is contrary to two of the prime tenants of the Affordable Care Act (ACA): The coverage of preexisting conditions and access to all. But more than being contrary to ACA core values, it is contrary to American values by institutionalizing prejudice and blaming the victim. (David S. Seres, 2/22)

The Tennessean: Tennessee Quit Week A First Step To Healthier Nashville
Of the thousands of heart and lung operations I have performed, the most common cause of the underlying disease in these patients was a single voluntary behavior: smoking. ... Nashville's smoking rates are higher than the national average and that of all our peer cities. We must aggressively address this most preventable cause of premature disability and death. (Bill Frist, 2/22)

The Washington Post: Dear Conservatives: Abortion Clinics Don’t ‘Target’ The Black Community
A few weeks ago, Rep. Sean Duffy took to the House floor to scold black lawmakers like me. Citing high abortion rates among African American women, the Wisconsin congressman accused abortion providers of preying on minority communities. ... Groups like the Guttmacher Institute — an independent reproductive health research organization — have debunked this assertion with data showing that fewer than 1 in 10 abortion providers are in majority-black neighborhoods. (Rep. Gwen Moore, D-Wis., 2/16)

JAMA: Antiretroviral Preexposure Prophylaxis: Opportunities And Challenges For Primary Care Physicians
Comprehensive primary care involves solicitation of information about behaviors that may not be congruent with clinicians’ personal beliefs. Because most adults are sexually active, it behooves primary care physicians to ask their patients about their sexual and drug activities to determine their risk for HIV and STDs. Clinicians should be able to offer counseling and testing to rule out these infections and consider those individuals appropriate for triage to PrEP [antiretroviral preexposure prophylaxis] and more frequent STD screening. Antiretroviral chemoprophylaxis is not a panacea, but it has been proven to decrease HIV transmission for diverse groups of high-risk persons and could increase engagement in sexual health care. (Kenneth H. Mayer, Douglas S. Krakower and Stephen L. Boswell, 2/18)

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