The American Bear

› 30 Million to Remain Uninsured Under Obamacare | Single Payer Action

socialismartnature:

we need quality universal health care for all; not a mandatory system of market-driven private-insurance-based health care delivery that leaves millions uninsured and millions more unable to afford using the insurance they have.

profits and patients don’t mix.

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A study released today finds that between 29.8 million and 31.0 million people will remain uninsured after the implementation of the Affordable Care Act in 2016.

The research team from Harvard Medical School and the City University of New York School of Public Health projects that the demographic composition of today’s uninsured population will change little under Obamacare.

› Salvadoran woman, "Beatriz" will be allowed to end pregnancy | The Guardian

A seriously ill Salvadoran woman whose struggle to get a medical abortion drew international attention has received permission to end the troubled pregnancy with a caesarean section.

El Salvador’s health minister approved the C-section for the 22-year-old woman who suffers from kidney failure and lupus, a day after the supreme court ruled that she could not have an abortion despite her lawyers’ appeal that the pregnancy was life-threatening.

Ultrasound images indicate that her fetus was developing with only a brain stem and was given no chance of surviving.

The case of the mother known only as Beatriz drew widespread attention and criticism as she sought to end the pregnancy in a country with some of the strictest abortion laws in Latin America. Salvadoran laws prohibit all abortions, even when a woman’s health is at risk, and the woman and any doctor who terminated her pregnancy would face arrest and criminal charges.

› Anti-Polio Campaign Worker Shot Dead in Pakistan | NYTimes.com

A volunteer in a polio vaccination campaign was killed and her colleague wounded in an attack by militants near Peshawar on Tuesday, a district administration official said.

The volunteers were going door to door to give oral anti-polio drops to children in Sheik Muhammadi, on the southern fringes of Peshawar, when two gunmen opened fire on them and fled, according to the deputy city commissioner of Peshawar, Javed Marwat. A police official said that a search operation had begun but that no arrests had been made.

Mr. Marwat said the women had not asked to be accompanied by security.

“Probably, they thought it was good not to go with a police escort and become a target,” he said.

The government of Khyber-Pakhtunkhwa, the surrounding province, announced after previous attacks that it would send police escorts with polio vaccination teams. Most such violence has been attributed to the Pakistani Taliban, who have criticized vaccination efforts as a cover for Western espionage.* Also, religious extremists claim that the real aim of vaccination campaigns is to sterilize Pakistan’s Muslim population.

* Unmentioned in the Times piece is that the suspicions of the Taliban and backlash against polio workers were heightened after a highly unethical fake vaccination program was implemented to track down bin Laden in Abbottabad (in other words, blowback). From Jim White:

Health workers are on the cusp of making polio the second disease after smallpox to be completely eradicated from the planet. The latest plan forecasts eradication by 2018, but a huge barrier is that conservative Islamic groups view Western vaccination programs as attempts to sterilize Muslims. In addition, the participation by Dr. Shakeel Afridi in a bogus vaccination program set up by the CIA to obtain DNA samples from Osama bin Laden’s compound added fresh fuel to the belief that vaccination programs also are used to spy on Muslims.

› Sad Victory for Pakistan’s Taliban: Child Diagnosed With Polio in Region Where Vaccinations Were Denied | Jim White

While much attention is appropriately focused on the horrific and brutal attacks by Pakistan’s Taliban on secular political parties as the country approaches elections in its first-ever transition from one civilian government to another, we have news today of a sad triumph by the Taliban as a child in North Waziristan has been diagnosed with polio after the Taliban successfully shut down polio immunizations there last summer.

Health workers are on the cusp of making polio the second disease after smallpox to be completely eradicated from the planet. The latest plan forecasts eradication by 2018, but a huge barrier is that conservative Islamic groups view Western vaccination programs as attempts to sterilize Muslims. In addition, the participation by Dr. Shakeel Afridi in a bogus vaccination program set up by the CIA to obtain DNA samples from Osama bin Laden’s compound added fresh fuel to the belief that vaccination programs also are used to spy on Muslims. Just under a month ago, a policeman protecting workers administering polio vaccine was shot and killed:

The latest attack took place in the afternoon in the Par Hoti neighborhood of the Mardan district in Khyber-Pakhtunkhwa Province. The policemen, Raj Wali and Mohammad Ishfaq, were accompanying two female workers on the second day of a three-day anti-polio drive, said Wajid Ali, a local police official.

The policemen were standing guard in the street as the health workers administered drops inside a house when an unidentified gunman, who appeared to be in his early 20s, walked up to them and opened fire. Mr. Wali was killed and Mr. Ishfaq was wounded, Mr. Ali said in a telephone interview. The gunman escaped.

That killing followed the deaths of eight vaccine workers last December and the violence has led to a significant interruption in the distribution of the vaccine:

In December, at least eight people engaged in polio vaccinations were shot dead in Karachi and the north-west, and in January and February two police officers were killed in similar attacks.

The UN said last month that some 240,000 children have missed vaccinations since July in parts of Pakistan’s tribal region, the main sanctuary for Islamic militants, because of security concerns.

And it is from the tribal area of Waziristan where we have today’s sad news of a child being diagnosed with polio:

A child has contracted polio for the first time in Pakistan’s militant-infested tribal belt since the Taliban banned vaccinations a year ago, a UN official said Monday.

“The new case has been detected in North Waziristan where we had been denied access in June last year,” the World Health Organization’s (WHO) senior coordinator for polio eradication in Pakistan, Elias Durry, told AFP.

Durry fears that this case is not likely to be isolated:

“We are worried because this new case comes as an example of a bigger impending outbreak of disease in the region,” the WHO official said.

In addition to making vaccination drives shorter and lower profile while working closely with security, the executive summary (pdf) for the new polio eradication plan has a key step of outreach to religious groups:

4. Religious leaders’ advocacy: markedly step up advocacy by international, national and local Islamic leaders to build ownership and solidarity for polio eradication across the Islamic world, including for the protection ofchildren against polio, the sanctity of health workers and the neutrality of health services.

Unfortunately, I don’t see an open call in the plan for bringing about an end to intelligence agencies undertaking new vaccination ruses, although “the neutrality of health services” would seem to touch on it. Meanwhile, Afridi has started a hunger strike in a desperate attempt to keep his name in the headlines.

› Obama Administration Continues Blocking Access to Emergency Contraception | Kate Sheppard

On Wednesday night, President Barack Obama’s administration indicated that is challenging an April court decision that would make emergency contraception available to everyone without a prescription. The announcement means that, after a decade of fighting between reproductive rights advocates and the Food and Drug Administration over this issue, there’s still no resolution.

In 2011, the FDA approved Plan B One-Step, one of the most common forms of emergency contraception, for purchase over-the-counter for all women. But the Department of Health and Human Services overruled the FDA, instead making it available without a prescription only to women ages 17 and older. Reproductive rights groups sued, and on April 5, Federal District Court Judge Edward R. Korman issued a scathing decision that said that the administration’s policy was “was politically motivated, scientifically unjustified, and contrary to agency precedent.” His ruling directed HHS and the FDA to make emergency contraception available to all by May 5.

On Wednesday evening, however, the Department of Justice announced that it is appealing Korman’s ruling. “The Court’s Order interferes with and thereby undermines the regulatory procedures governing FDA’s drug approval process,” said the DOJ in a statement.

The DOJ statement is misleading. The FDA actually approved Plan B for women of all ages in 2011. Then HHS interfered.

The appeal comes a day after the FDA announced that it has approved the sale of Plan B One-Step to women ages 15-and-over without a prescription. In its announcement, the FDA claimed that decision “is independent of” the lawsuit and “is not intended to address the judge’s ruling.” However, as Washington Post’s Sarah Kliff reports, the DOJ’s appeal uses the FDA’s decision to make its case:

The Justice Department, in fact, relied on that new decision to argue that none of the federal case’s plaintiffs — who are 15 or older — would be harmed by a court decision to delay Korman’s ruling from taking effect.

“The approval has the effect of ensuring that all of the plaintiffs in this case (including the youngest of them) now have access without a prescription and without significant point-of-sale restrictions to at least one form of emergency contraceptive containing levonorgestrel,” the Justice Department argued, referring to the active ingredient in Plan B.

The judge’s ruling clearly stated that Plan B should be available to everyone without a prescription and without government-issued ID. The Obama administration is not complying with that order. This doesn’t sound like the same Obama who, just last week, said in a speech to Planned Parenthood that he is a president “who is going to be right there with you, fighting every step of the way” on reproductive rights.

The administration’s latest position seems to be that lowering the age to 15 is a compromise. Yes, it is two years younger than the previous limit, and the FDA’s new guidelines would also mean Plan B is now available on the shelf and not only during pharmacy hours. But it still means that women will need to have some manner of government-issued ID to obtain it. Not every woman has that sort of ID—especially 15- and 16-year-olds that can’t yet drive and don’t have a passport, or simply don’t want to have a cashier know their names.

The Center for Reproductive Rights, which filed the lawsuit challenging the restrictions, said on Thursday that they will continue to press for universal access. “We are deeply disappointed,” CRR president Nancy Northup said in a call with reporters, pledging to “continue the battle in court to remove these arbitrary restrictions.”

› Beyond Obamacare: How A Single Payer System Can Save Health Care in the U.S. | Dave Dvorak, M.D.

The ACA of 2010, known widely as Obamacare, is expected to extend coverage to 32 million more Americans. But it accomplishes this goal primarily by expanding the current fragmented, inefficient system and maintaining the central role of the private insurance industry in providing coverage. As a result, the ACA is expected to do little to rein in health care spending. Furthermore, it will fall far short of achieving universal coverage, as tens of millions of Americans will remain uninsured after its full implementation.

The central feature of a single-payer health care system would be one health plan that covers all citizens, regardless of their employment status, age, income or health status. Having a public fund that pays for care would slash administrative inefficiencies and eliminate profit-taking by the private insurance industry.

Under a single-payer system, the way society pays for health care would change, but the market-based health care delivery system would remain. Physicians and hospitals would continue to compete with one another based on service, quality of care and reputation. The chief difference is that they would bill a single entity for their services, rather than numerous insurers.

Individuals would benefit immensely by having continuous coverage that is decoupled from their employment. This would alleviate “job lock,” in which people remain in undesirable employment situations in order to maintain coverage. In a single-payer system, individuals could choose to see any provider, in contrast to the current system in which choice is restricted to those who are in-network. Deductibles and copays would be minimal or eliminated, removing cost as a barrier to obtaining needed care.

A single-payer system would be funded through savings on administrative costs, along with modest taxes that would replace the premiums and out-of-pocket expenses currently paid by individuals and businesses. The cost savings to individuals, businesses and government would be considerable. The nonpartisan U.S. General Accounting Office concluded that single- payer health care would save the United States nearly $400 billion per year, enough to cover all of the uninsured.

Physician support for a simplified, universal health care system is robust and growing. A 2008 survey published in Annals of Internal Medicine found that 59 percent of physicians supported a national health insurance system—up from 49 percent in 2002. Physicians for a National Health Program, a national organization advocating for single-payer reform, reports a membership of 18,000. …

Recognizing the implausibility of achieving single-payer reform at the national level in the current political climate, many single-payer advocates have turned their attention to state-level reform. The ACA provides for “state innovation waivers” to be granted beginning in 2017, allowing states to implement creative plans they believe would work best for them. With this in mind, organized single-payer movements have taken root in states as varied as Colorado, Hawaii, Illinois, New York, California, Oregon and Vermont. Vermont’s governor and Legislature passed a law in 2011 setting the path for the state to move toward single payer.

… With nearly 50 million uninsured people in the United States and skyrocketing health costs, the need for profound reform of our health system could not be more clear. The ACA is a start, but it will fall far short of achieving universal coverage, and it allows unsustainable spending growth to continue. Single-payer health care would eliminate administrative waste and inefficiency, thereby creating an opportunity to achieve truly universal, cost-effective health care.

› ObamaCare Clusterfuck: Virginia bans abortion coverage on health exchanges | Lambert Strether

Of course, all this was fully predictable when Obama incorporated the Hyde Amendment into ObamaCare by executive order.

› BREAKING NEWS: A judge has ordered the FDA to make the morning-after pill available over-the-counter nationwide—no matter how old you are.

shortformblog:

Previously, the pill required a prescription for girls aged 16 or under. In 2011, Health and Human Services secretary Kathleen Sebelius made a controversial move, blocking an FDA recommendation that the pill be available over-the-counter to anyone.

(via robotmonastery)

› The VA is Severly Backlogged, and It May Be Costing Lives

govtoversight:

Military veterans experience “excessive wait time” for medical care, leading to higher incidences of preventable hospitalizations and death, according to a scientific research council.

Drawing on the findings of recent government and scholarly studies, a report issued this week by the Institute of Medicine paints a picture of a healthcare system that is understaffed, undertrained, and inaccessible.

Read more on POGO’s blog.