Healthcare

I will be meeting with several of you who work on Capitol Hill March 11 and 12, far away from the rocky coast of Maine where I live and work as a scientist researching the impacts of chemicals on our environment and our bodies. I am grateful to those of you who are giving me time to share some important science news about firefighters. Here is what I would like for you to know:

There is no doubt that firefighting is a dangerous occupation. Firefighters put their lives at risk every time they enter burning buildings to save the victims of fire. Tragically, we know that firefighters, our altruistic first responders, are suffering from elevated rates of several cancers – prostate, testicular, bladder cancer, non-Hodgkin’s lymphoma, multiple myeloma – that are thought to be related to their exposure while firefighting and after, during the overhaul (clean-up) of fires.

While the ongoing Congressional debate about deficit reduction and Medicare may seem far removed for most Americans, it is an issue that strikes very close to home for one particular group of patients: the approximately half million Americans living with kidney failure (also known as end stage renal disease). For this group of patients Medicare functions as a lifeline, ensuring access to three-times weekly dialysis treatments that are crucial to survival.

Literally, without dialysis or a transplant, individuals with kidney failure would die.

America claims to revere its veterans and has demonstrated an admirable commitment to those returning from our wars with visible wounds. Public and private organizations, as well as countless individuals, have extended their generosity and compassion to those heroic men and women who have served our country. But sadly, we seem to turn a blind eye toward the very real and often debilitating effects of extended combat exposure and the invisible wounds it causes. Marked less by physical scars and missing limbs, many soldiers returning from war face serious diseases of addiction and mental illness as they struggle to readjust to civilian life.

Information technology is helping to transform the way healthcare is delivered and managed, just as it has transformed so much of our daily lives. But making use of sensitive personal data carries risks, and every step must be taken to ensure that individuals’ most intimate information is protected against security breaches and misuse.
 
That’s why we are concerned about the Obama administration’s proposal to have the Office of Personnel Management (OPM) create a new, central database of health insurance claims as part of its management of multi-state insurance plans under the new healthcare reform law.

On March 1, China’s ban on imported American pork, cattle, and turkey products will go into effect. This will create tremendous ripple effects in American agriculture and international markets. Even people who do not follow food safety news have likely heard of the looming trade disputes with China, Russia, Taiwan, and the European Union over the U.S.’s use of the controversial livestock feed additive ractopamine.  
 
Public outcry from members of Congress, the Secretary of Agriculture, and the U.S. Trade Representative have not stopped China or Russia from moving forward with their bans. These are not the first nations to ban ractopamine, and as other countries are bound to follow suit, it is about time we ask ourselves the cold, hard question: why does American agriculture continue to shutter valuable foreign markets at the expense of agribusiness dogma?

When a new Congress convenes, groups that represent patients, businesses and industries traditionally outline their legislative goals for the session. The National Community Pharmacists Association, whose members own and operate some 23,000 independent pharmacies, is no different. We’ve been doing so since 1898, when we joined together to oppose a tax imposed on medicines to help finance the Spanish-American War.
 
Today, our members wear two hats: highly trained health care professionals (six-year degree programs) and small business owners who employ more than 300,000 people nationwide. As such, our members know the critical importance of keeping patients and bottom lines healthy.

Volumes have been written linking the U.S. health care system's cost problems with doctors ordering too many diagnostic tests. Much of that, however, is based on old information: the fact of the matter is that spending on medical imaging is down over 20 percent since 2006. Comparably little attention, though, has been given to the relative medical necessity of these tests and when repeat testing may be not only useful, but actually advisable.

Using every inch of his bully pulpit, President Obama forcefully framed his second-term agenda in Tuesday's State of the Union address, from combatting climate change to spending more on infrastructure to raising taxes on the rich. 

However, in a remarkable example of whistling past the graveyard, the president did little to substantively address the biggest crisis we face: the federal budget. 

The president needed only to look at last week’s report by the Congressional Budget Office to see the scale of the problem. 

In their budget and economic outlook for 2013-2023, CBO sees near trillion-dollar annual deficits, at least $7 trillion in new debt, and more spending on interest payments on the debt ($5.4 trillion) than on Medicaid ($4.3 trillion).

The ghastly tragedy in Connecticut, the rising number of military and veterans suicides, and too many other stories have once again moved the spotlight onto mental illness.  Pundits and politicians, with the occasional expert to provide context, remind Americans that our country needs to improve treatment and services to disturbed individuals who might be at risk of committing such heinous acts. The words all sound good, but the likelihood of actually transforming the care of the mentally ill is extremely low if the experience over the past 10 years with the DoD and VA are indicative. Compared to other areas of medicine, mental health has improved little in the 40 years that I have been working in the field. In this, as in so many areas of life, what has happened in the treatment of brain disorders and mental illness for combat veterans can been seen as a microcosm of our society as a whole. There are more similarities than differences in this field across the military and the civilian communities.

In this era of deficit debates and fiscal cliffs, Washington, D.C. is focused on large numbers and complex math. In the State of the Union address, the President discussed many numbers and there is no doubt robust debate filled with even more calculations will follow. And these numbers often lead to very differing views. There is one thing, however, most policymakers can agree on. The arbiter of Washington’s numbers is the Congressional Budget Office (CBO), whose accounting is considered the gold standard on budget issues.
 
While it does not recommend policies, CBO evaluations can serve as the basis for policy discussions across a range of budgetary and economic issues, from education and housing to energy and healthcare. When CBO speaks, Washington listens.