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MEDICINE AND HEALTH

Richard T. Bosshardt Lipstick on a Pig Recognizing that DEI has acquired a toxic reputation, the American College of Surgeons tries to rebrand it—while retaining its core premises.

https://www.city-journal.org/article/lipstick-on-a-pig

The American College of Surgeons is trying to expunge the term DEI from antiracism and critical race theory initiatives. An attempted rebranding was inevitable, given how rapidly the term and its associated programs have fallen out of favor. Universities, corporations, and institutions of all kinds are eagerly rechristening, if not dismantling, their DEI departments and laying off their DEI administrators.

The new name of the game is “Inclusive Excellence.” Like “diversity, equity, and inclusion,” it has a nice ring to it and even seems to signal a return to a focus on merit. This is not the case. Search the ACS website for the Office of Diversity, and you’ll be redirected to the Office of Inclusive Excellence. The ACS has renamed its DEI Toolkit, introduced in December 2023, the ACS Inclusive Excellence Resource and Implementation Toolkit.

A perusal of the materials reveals that little if anything has changed in the program’s content and focus. It continues to promote the discredited Implicit Association Test as a measure of one’s implicit bias. It still claims that achieving proportionate representation of identity groups somehow makes organizations better. It adopts the same underlying DEI premise: that disparities of representation always indicate discrimination.

Poll: Majority Favors Federal Ban on Transgender Surgeries for Minors By Eric Lendrum

https://amgreatness.com/2024/10/14/poll-majority-favors-federal-ban-on-transgender-surgeries-for-minors/

A new poll shows that nearly two-thirds of voters support a federal ban on so-called “sex change” operations for minors, as Democrats continue pushing transgenderism on children across the country.

As reported by Just The News, the new survey from the Center Square Voters’ Voice Poll found that 59% support the ban, including 82% of Republican respondents and 56% of independents. Only Democrats were against the ban, with just 36% of Democratic respondents favoring it.

Along gender lines, men were more likely to support such a ban than women, with 63% of men favoring it while 56% of women voiced their support for it. When broken down by ethnicity, a total of 61% of White respondents favored the ban, while 46% of black respondents favored it, compared to 32% who opposed it and 22% who remained unsure.

The age groups which most favored the ban were the 45-54 and 54-65 demographics, both at 61% support. Meanwhile, the 18-34 bloc supported such a ban by a narrow majority, at 52%.

Lastly, 55% of voters with a college degree supported such a proposal compared to 61% of voters without a college degree, while 61% of voters with children supported a ban, compared to 52% of voters without children.

Transgenderism, the false and scientifically-debunked belief that there are more than two genders, and that anyone can simply change their gender at any time, has been promoted by Democrats for the last several years; the ideology has only recently begun facing serious pushback from conservatives, with laws banning such treatments for minors in 25 different states.

Why Therapy Is Broken Eleanor Cummins Everyone is telling one another to “get help,” but few acknowledge that the practice is often flawed.(Published September 26, 2022)

https://getpocket.com/explore/item/why-therapy-is-broken?utm_source=pocket-newtab-en-us

An hour a week in a shrink’s office is increasingly treated as a prerequisite for a healthy, happy life. There, we imagine, friends learn new coping skills and enemies realize the errors of their ways. Everyone is “healed.” Therapy has been marketed as a panacea for all kinds of issues, from fixing a bad personality to ending racism. Refusing to seek treatment becomes a red flag, while fluency in “therapy-speak” is all but mandatory. Professional help has even infiltrated our leisure hours: Reality TV shows like Couples Therapy, podcasts from This Is Dating to Where Should We Begin?, and “therapy in a box” card games, some actually designed by psychoanalysts, abound.

Unfortunately, as anyone who’s actually tried it can tell you, therapy often sucks.

Anywhere from 50 to 75 percent of people who go to therapy report some benefit—but at least 5 percent of clients get worse as a result of treatment. (For people from marginalized groups, harmful outcomes may be even more common.) The remainder report no clear benefit at all. Plenty of would-be clients go once and, feeling alienated, never return. Others keep trying, even as it becomes clear they aren’t really getting what they need, whatever that is.

But the American mental health care system has hardly acknowledged the existence of bad therapy, let alone taken steps to fix the problem. Instead, in the wake of the Covid-19 pandemic, which sent the demand for therapy soaring, the American Psychological Association and other organizations seemed to prioritize the quantity of available appointments over the quality of any resulting therapy. The rise of app-based mental health care, like BetterHelp and Talkspace, has only made this landscape harder to navigate.

The result is that everyone is telling everyone else to go to therapy, but “nobody really creates space to have dialog about, ‘OK, if it doesn’t work, let’s talk about why,’” says psychotherapist Ben Fineman, cohost of the Very Bad Therapy podcast with Carrie Wiita. That’s partly out of fear of uncertainty, which therapists dislike as much as anyone, and partly because reforming mental health care is complicated. But ignoring these shortcomings is only perpetuating the suffering therapy promises to heal.

Harris’ Latest Health Care Plan’s Spending Will Bankrupt America

https://issuesinsights.com/2024/10/10/harris-latest-health-care-plans-spending-will-bankrupt-america/

Those who have suffered through Obamacare, with its soaring premiums, longer waits for care and millions still left without insurance, should beware. Because Vice President Kamala Harris, if elected, has something equally bad in store for you.

Originally, Harris’ put forward a grab bag of “fixes” for Obamacare, which has now been in force for 14 years. Among her recent ideas, according to CNN, include “making permanent the enhanced Obamacare premium subsidies; broadening the $35 monthly cap on insulin and $2,000 annual limit on out-of-pocket costs to all Americans, not just Medicare enrollees; speeding up Medicare drug price negotiations; and working with states to cancel patients’ medical debt.”

All sounds kind of innocent, right? It isn’t. It’s all part of the slow-but-steady move toward Medicare for All, the plan to create nationalized health care in the U.S., and abolish private insurance. It would be a disaster.

Though Harris has verbally backed away from supporting Medicare for All, her most recent idea, unveiled this week, is a dangerous step in that direction:

“The Veep on Tuesday used a friendly interview on ‘The View’ to lay out her plan to require Medicare to cover long-term home care for all seniors who can’t live independently,” the Wall Street Journal opined. “She said the new benefit would help the ‘sandwich generation’ of Americans who take care of children and aging parents. She put no cost estimate on this new taxpayer obligation, but home care on average costs $288,000 a year, so you get the idea.”

“It’s just about helping an aging parent or person — you know — prepare a meal, put their sweater on,” Harris said on the campaign trail. In fact it’s the last piece in a cradle-to-grave Medicare for All system.

How to Fight the Left’s Politicization of Medicine By Jack Butler

https://www.nationalreview.com/2024/10/how-to-fight-the-lefts-politicization-of-medicine/

A new study challenges one of the more popular reasons cited for introducing left-wing ideology into medicine, and it outlines an agenda for making health care apolitical.

‘A sick society must think much about politics, as a sick man must think much about his digestion,” C. S. Lewis wrote. “To ignore the subject may be fatal cowardice for the one as for the other.” In the national delirium of a presidential election, the maladies of politics impose themselves on our minds to an even greater degree.

Unfortunately, the current state of the medical field is not much of an analgesic. In recent years, left-wing ideology has thoroughly penetrated medicine. But new research undercuts one of the more popular academic buttresses of this blatant politicization. It’s more than enough to make one wonder if a movement that bills itself as pro-health might actually be iatrogenic.

Health care has not been immune from the whole-of-society effort by the Left to take control of institutions and subordinate them to its aims. Medical schools, journals, professional societies, continuing-education courses, and other institutions of the medical field now tilt left, as I documented last year.

Examples abound. The official publication of the American College of Emergency Physicians recently published a case for DEI in medicine. Harvard’s School of Public Health is offering a “Settler Colonialism” course. The Cleveland Clinic is currently being investigated for possible discrimination against white patients. The important roles academia and the government play in the medical field make this reality sadly unsurprising.

It still may have been a surprise to some when a related research paper became fodder for the Supreme Court. In her dissent from the Supreme Court’s majority opinion that overturned affirmative action last year, Justice Ketanji Brown Jackson wrote that the practice “saves lives” (indirectly), citing a 2020 study to claim that high-risk black newborns are twice as likely to live if they have a black physician. What the study actually found was that half as many black newborns died while being treated by a black physician as when treated by a white physician, while the survival rate was above 99 percent in either case.

Women, Children, Disabled Pay The Price For Obamacare’s Medicaid Expansion Sally C. Pipes

https://issuesinsights.com/2024/09/25/women-children-disabled-pay-the-price-for-obamacares-medicaid-expansion/

Obamacare greatly expanded Medicaid eligibility. As a result, about 20 million able-bodied, working-age adults who were previously ineligible are now enrolled in the program. 

But as a new report from the Paragon Health Institute makes clear, their gains have come at the expense of the pregnant women, children, and people with disabilities that Medicaid was established for. 

The harm to these legacy beneficiaries, and to taxpayers, will only mount unless Congress fixes the perverse incentives that Obamacare created for the nation’s flagship health program for the poor.

Obamacare directed states to expand Medicaid eligibility to able-bodied adults earning up to 138% of the federal poverty line. Forty states and the District of Columbia have complied.

Previously, eligibility had been restricted to vulnerable people — like nursing home residents with virtually no assets, or minor children, or pregnant women who lacked other health coverage. 

Obamacare incentivized states to enroll able-bodied adults by having the federal government cover most of the cost. 

For the legacy Medicaid population, the feds normally pick up between half and three-quarters of enrollees’ health care costs; states foot the rest of the bill. For the expansion population, Washington initially picked up 100% of the cost. Now the federal government covers 90%. 

Leor Sapir, Mungeri Lal HHS Has Misled on Gender Medicine The Department of Health and Human Services’ documented failures to hold gender medicine to scientific standards have happened under both Republican and Democratic administrations.

https://www.city-journal.org/article/hhs-has-misled-on-gender-medicine

In 2015, the Centers for Medicare & Medicaid Services (CMS) accepted a formal request to initiate a national coverage analysis for “gender-reassignment surgery.” When making these coverage determinations, CMS is legally obligated to evaluate relevant clinical evidence and answer the question: Is the evidence sufficient to conclude that the application of the item or service under study will improve health outcomes for Medicare patients? In June 2016, CMS released its 109-page analysis, which it made open for public comment. The agency published its final decision memo two months later. The differences between the two documents were revealing—and disturbing.

At first sight, the summaries of both memos seemed similar. Each mentioned that the CMS was not issuing a national coverage determination on “gender-reassignment surgery” for Medicare beneficiaries with gender dysphoria. Such determinations, the CMS said, would continue to be made by local contractors on a case-by-case basis. On closer examination, however, the final document included substantial changes. These were not corrections. They amounted to a systematic effort to scrub any reference to the evidence of the harms associated with these surgeries.

The agency’s shifting analysis of gender surgery is glaring enough. But it is just one of several examples, between 2016 and the present day, of how key figures and agencies within the U.S. Department of Health and Human Services have misled the American public about the evidence for “gender-affirming care.”

Start with the tale of two memos. To conduct a proper analysis of the clinical evidence, CMS identified a large number of publications related to “gender-reassignment surgery.” As CMS explained:

Studies with robust study designs and larger, defined patient populations assessed with objective endpoints or validated test instruments were given greater weight than small, pilot studies. Reduced consideration was given to studies that were underpowered for the assessment of differences or changes known to be clinically important. Studies with fewer than 30 patients were reviewed and delineated, but excluded from the major analytic framework. Oral presentations, unpublished white papers, and case reports were excluded. Publications in languages other than English were excluded.

Thirty-three publications, ranging from 1979 to 2015, were eventually identified and included.

Biden-Harris Price Controls Causing Senior Drug Prices to Skyrocket A recent analysis warns that drug price controls scheduled to begin in 2026 will likely lead to higher costs for millions of seniors and disabled Americans who rely on Medicare Part D. Martin Hoyt

https://amgreatness.com/2024/09/19/biden-harris-price-controls-causing-senior-drug-prices-to-skyrocket/

If there’s one axiom, we all know about Washington, D.C., is that it’s full of well-intentioned policies and unintended (read: harmful) consequences. A recent reminder of unintended policy consequences is the so-called Inflation Reduction Act (IRA). The IRA was passed in August 2022, and according to its champions in Congress and the White House, it was intended to reduce the federal government budget deficit, make investments in renewable energy, lower drug prices, and fight inflation.

Two years later, we’ve unfortunately re-learned that noble intentions don’t necessarily produce good policy. The IRA has failed to achieve its objectives in many ways. One significant problem involves the introduction of drug price controls, which take effect in 2026. Due to the IRA, the federal government now has wide-ranging authority to set the price of drugs through what’s known as the Medicare Drug Price Negotiation Program.

A recent analysis warns that these pricing provisions will likely lead to higher costs for millions of seniors and disabled Americans who rely on Medicare Part D. This shouldn’t come as a surprise – price controls simply don’t work, and when they’re implemented, someone will eventually have to pick up the tab.  Nor should it be surprising that government spending doesn’t reduce inflation. History shows quite the opposite.

The first group of impacted drugs includes ten medicines that have been selected to have a “maximum fair price” (MFP) set under the IRA. In 2024, Medicare beneficiaries typically pay fixed copays for most of these drugs. For millions of these beneficiaries, artificially fixed-drug costs will slow their progression toward their Part D out-of-pocket limit, making them pay more in out-of-pocket costs.

The Voter-Registration Guide Will See You Now By Stanley Goldfarb

https://www.nationalreview.com/2024/08/the-voter-registration-guide-will-see-you-now/

A worrisome new consensus in the medical community holds that doctors should be as concerned with politics as they are with medicine.

‘We again discussed . . . the importance of voting and the safety, security, and effectiveness of voting by mail.”

These probably aren’t the words you’d expect to see in a medical record. Yet that’s what a medical professional at a prominent northeastern hospital wrote earlier this year after seeing a patient. The record, a de-identified version of which was provided to my organization, shows a new and profoundly concerning trend in medicine: Leftists are making the doctor’s office a major cog in their voter-registration and turnout machine.

The movement has been building since at least 2020, growing out of the woke fixation with so-called “social determinants of health.” This concept holds that medical professionals should be as concerned with welfare, housing, and climate policy as they are with diagnosing illnesses and prescribing medications.

As the argument goes, such policies affect patient health, so health care has a duty to shape them. In 2022, the American Medical Association — which is thoroughly captured by woke ideologues — passed a resolution asserting that “voting is a social determinant of health.”

Statements from such influential sources signal to medical employers and educators that doctors should make voter registration a central part of their work. Medical journals are applying further pressure by publishing a slew of opinion articles and tendentious studies arguing that voter registration in medical settings will improve health equity.

Having practiced and worked in academic medicine for 50-plus years, I know that when the New England Journal of Medicine says jump, the medical establishment collectively leaps.

Joel Zinberg Often Wrong, Never in Doubt More than four years since the advent of Covid, public authorities keep pushing health practices contrary to medical and scientific knowledge.

https://www.city-journal.org/article/covid-public-authorities-pushing-health-practices-contrary-to-medical-and-scientific-knowledge

Times have changed. Two years ago, tennis great Novak Djokovic could not play in the U.S. Open tournament. It was not because he had Covid-19 and posed a danger to fellow athletes and fans. Djokovic could not come into the country because of President Biden’s proclamation banning the entry of unvaccinated noncitizen air travelers into America.

Now, U.S. sporting officials let American sprinter Noah Lyles compete at the Olympics with an active case of Covid-19, putting his fellow athletes at risk of contracting the disease and impairing their performance.

Lyles tested positive on Tuesday. But he was allowed to run the 200-meter semi-final on Wednesday and the final Thursday, despite having a fever. It was hard not to notice Lyles talking with and hugging other athletes, exposing them at a time when he was surely contagious. Yet, Lyles said that he never considered withdrawing from the event. Nor did he notify anyone of his condition outside of the USA Track & Field medical staff that allowed him to compete.

Lyles was not alone. The World Health Organization reported that at least 40 Olympic athletes have tested positive for the virus. Yet the International Olympic Committee has removed all requirements for health measures or notifications. And the Paris Olympics officials have likewise taken a hands-off approach, letting athletes and teams determine for themselves how to respond to infection.

Amid this change, however, one finds a Covid constant: public authorities have consistently promulgated health requirements that have been, and remain, contrary to medical and scientific knowledge. Imposing a vaccination requirement on noncitizen air travelers, but not citizens and other types of travelers, made zero sense. Moreover, it has long been clear that the vaccine’s primary utility is to protect the person vaccinated from severe disease—the guard against infection is limited and short-lived; thus, vaccine mandates could not be justified as protecting the public.

Public authorities also seemed intent on denying the existence of natural immunity resulting from earlier infections. In Djokovic’s case, he had already had Covid twice. It was common medical knowledge that natural immunity is generally as good as or better than vaccine immunity, though, in the case of Covid, the public health authorities tried to ignore this for years. By April 2022, even Anthony Fauci acknowledged that natural immunity was just as protective as vaccinations for Covid.