Category: The Lancet
Cycling safety concerns grow in US cities
Volume 394 Number 10211 16 November 2019
WORLD REPORT As more bicycle riding is encouraged for health and environmental reasons, an increase in cycling deaths is causing a public health dilemma in the USA. Susan Jaffe reports.
A record number of cycling deaths in the USA is attracting scrutiny from the US Congress, city officials, and the National Transportation Safety Board (NTSB), the government agency better known for investigating aeroplane crashes and other transportation disasters. …Last year, 859 cyclists were killed in road traffic crashes, the highest number in the USA since 1990, and a 6·3% increase since 2017, according to research from the US Department of Transportation’s National Highway Traffic Safety Administration published last month.
…In a preliminary report issued last week, the NTSB recommended that public officials take several steps to reduce the number of cycling deaths. The last time it examined bicycle safety was 47 years ago. [Continued here]
…Congress and President Trump take on high drug prices
Volume 394 Number 10204 28 September 2019
WORLD REPORT Proposals from the White House and Congress to lower prescription drug costs, which both rejected more than a decade ago, are making a comeback. Susan Jaffe reports.
The Trump administration’s Department of Health and Human Services (HHS) is the first federal health agency to claim they are “open” to the idea of importing cheaper drugs from Canada and overseas. And both Republicans and Democrats in Congress now advocate familiar strategies to rein in drug price increases. [Continued here]
…US Planned Parenthood leadership shake-up
Volume 394 Number 10195 27 July 2019
WORLD REPORT Planned Parenthood’s board of directors decided to remove Dr. Leana Wen her after only 8 months, igniting a public debate about how the prominent women’s health-care organisation should best protect a woman’s right to abortion.[Continued here]
…US Congress wants to take the surprise out of medical bills
Volume 393 Number 10191 29 June 2019
WORLD REPORT A Texas high school teacher gets an unexpected hospital bill for $110,000 that his health insurance policy doesn’t cover. What can Congress do about it? [Continued here]
…Trump administration limits fetal tissue research
Volume 393 Number 10189 15 June 2019
WORLD REPORT The move could threaten medical research advances, say scientists, as acquisition of new fetal tissue for research is substantially hindered. Susan Jaffe reports.
“Many discoveries now in clinical practice and wide research use have come from human fetal tissue”, said Irving Weissman, director of the Stanford Institute for Stem Cell Biology and Regenerative Medicine. “For these, there was—and still is—no substitute for human fetal tissue.”
…Anti-abortion groups praised the new policy, which would “separate federal research funding from the abortion industry”, said Melanie Israel, a research associate at the conservative Heritage Foundation… Yet how the new Trump research policy would reduce abortions is still unclear. “They are conflating pro-life issues and abortion with research”, said Jennifer Zeitzer, public affairs director at the Federation of American Societies for Experimental Biology. “But there’s no evidence that women are getting abortions so they can donate fetal tissue for research.” [Continued here.] …
Legal battles over abortion heat up in the USA
Volume 393 Number 10184 11 May 2019
WORLD REPORT Changes to Title X, several legal challenges, and a change to the Supreme Court composition could mean drastic changes for access to abortion in the USA. Susan Jaffe reports.
“We are the department of life…from conception until natural death, through all of our programmes”, US Department of Health and Human Services (HHS) secretary Alex Azar said earlier this year…. The government’s anti-abortion efforts have ignited lawsuits from Maine to California. Eventually, one or more of these cases are expected to reach the Supreme Court. With its newest arrival—Justice Brett Kavanaugh, whose nomination by Trump was championed by abortion opponents—the Supreme Court’s ideological balance has now shifted towards a conservative majority [raising] opponents’ hopes that a sympathetic court will diminish, if not overturn, Roe v. Wade...
Late last week, lawyers for the HHS appealed decisions by two federal court judges in Oregon and Washington state to temporarily halt new administration rules that would limit the information about abortion services that federally funded health-care providers can tell their patients.
“We are fighting back in the courts, we are fighting back in Congress and in state legislatures all across the country”, said Planned Parenthood president Leana Wen, noting that one in four women in the USA will have an abortion in their lifetime. “The public is with us when it comes to defending access to safe legal abortion, which people understand is part of the full spectrum of reproductive health care, which is health care.” [Continued here.]…
Doctors arrested in US crackdown on illegal opioids
Volume 393, Number 10182
27 April 2019
WORLD REPORT The multiagency operation hit five states and led to the arrest of 60 people. Perpetrators face up to
50 years’ prison sentence if found guilty. Susan Jaffe reports.
Arrests of 31 doctors, pharmacists, and other health care professionals for allegedly prescribing and distributing illegal opioids affected some 28,000 of their patients. That’s why Department of Justice officials are working with state health departments, the Centers for Disease Control and Prevention and the Department of Health and Human Services to help patients by “… bringing enforcement and [opioid addiction] treatment closer together…than ever before,” says Benjamin Glassman, the US attorney for the southern district of Ohio. [Continued here.]
…Scott Gottlieb steps down from US FDA leadership
Volume 393, Number 10176
16 March 2019
WORLD REPORT The announcement came as a surprise, prompting many to ask: Can the US FDA commissioner’s policies continue without him? Susan Jaffe reports.
Unlike some government agencies that can toil peaceably in relative obscurity, the FDA is frequently in the headlines. It is responsible for ensuring the safety of products that account for about 20 cents of every dollar US consumers spend—or US$2·5 trillion annually. …When Gottlieb became commissioner in 2017, the agency had an estimated 1000 vacancies which has now risen to 1400.[Continued here.]
…US lawmakers seek cuts in prescription drug prices
Volume 393, Number 10175
9 March 2019
WORLD REPORT A committee brought together Senators and drug company representatives to discuss why drug pricing in the USA is so high, but little progress was made, Susan Jaffe reports.
A much-publicized Trump Administration proposal allows — not requires — pharmaceutical companies to pass large rebates on to Medicare patients. Savings as much as 30 percent for seniors depend on companies’ voluntarily cutting prices but several top drug makers tell Senate committee they can’t promise to do so. [Continued here.]
…USA sets goal to end the HIV epidemic in a decade
Volume 393, Number 10172
16 February 2019
WORLD REPORT The unexpected announcement in the State of the Union address could set the start of a realistic agenda to end HIV/AIDS in the USA, provided funds are secured. Susan Jaffe reports.
Nearly an hour into his 90 min State of the Union address, President Donald Trump called for a government-run health-care programme “to eliminate the HIV epidemic in the United States within 10 years”.
Although the president has promised to get rid of the Affordable Care Act (ACA) along with its health insurance marketplaces and Medicaid expansion, these and other policies did not appear to dampen his enthusiasm. [Continued here.]…
NYC guarantees health care to all
Volume 393, Number 10169
26 January 2019
WORLD REPORT The mayor of New York City is not counting on Congress for solutions to its health-care problems, Susan Jaffe reports.
By encouraging patients to seek primary and preventive care instead of more expensive emergency care, city officials expect to save money and keep people healthy.
Profile: Leana Wen, President of Planned Parenthood
Volume 393, Number 10168
19 January 2019
“If there is one thing that I can accomplish as the President of Planned Parenthood, it’s to make clear that reproductive health care is standard health care, that women’s health care is standard health care and that we must view all aspects of health care as a fundamental human right”, said Wen. [Continued here.]…
State exemptions to the Affordable Care Act expanded
Volume 392, Number 10164
15 December 2018
WORLD REPORT In its latest blow to the ACA, the Trump administration provides guidance on how states can circumvent the health law. Susan Jaffe, The Lancet‘s Washington correspondent, reports.
Prospects for health after the US mid-terms
Volume 392, Number 10161
24 November 2018
WORLD REPORT After the mid-term elections, Susan Jaffe, The Lancet‘s Washington correspondent, looks at the consequences for health-care legislation in the USA.
Funding redirected to pay for immigrant detention centres
Volume 392, Number 10157
27 October 2018
WORLD REPORT A plan to expand immigrant children detention centres requires money from medical research and
health programmes. Susan Jaffe, The Lancet‘s Washington correspondent, reports.
Prospects for US single-payer national health care
Volume 392, Number 10149
1 September 2018
WORLD REPORT The single-payer national health-care bill, so-called Medicare for All, is gaining momentum with the public but is stalling in Congress. Susan Jaffe, The Lancet‘s Washington correspondent, reports.
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Trump’s second Supreme Court nominee, Brett Kavanaugh
Volume 392, Number 10144
28 July 2018
WORLD REPORT If confirmed, Kavanaugh could tilt the court toward the president’s views on US public health policy. Susan Jaffe, The Lancet‘s Washington correspondent, reports.
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Trump Administration’s Medicaid work rules hit a snag
Susan Jaffe | Washington Correspondent for The Lancet | 10th July 2018
After winning a federal court decision to stop Kentucky from requiring some Medicaid patients find paid or volunteer work to keep their coverage, beneficiary advocates are considering legal challenges to stop similar efforts in other states.
The victory may expose a major flaw in the Trump Administration’s effort to reshape the Medicaid program, advocates say. But others claim the flaw is in the court decision. [Continued here.]…
Gun violence research in the USA: the CDC’s impasse
Volume 391, Number 10139
23 June 2018
WORLD REPORT Months after the Trump Administration said that there is no ban on gun violence studies, the CDC still lacks the funding to proceed. Susan Jaffe, The Lancet‘s Washington correspondent, reports.
…Appeals for immediate federal action to make schools and communities safer have so far largely gone unanswered. And legislative efforts languish in Congress, as the chairman of a key congressional committee that oversees federal health programmes has so far resisted requests by its Democratic members to hold hearings on preventing gun violence [continued here].…
Trump unveils plan to cut drug prices
Volume 391, Number 10136
2 June 2018
WORLD REPORT The president’s wide-ranging plan to reduce prescription drug prices won’t be easy to achieve, experts say. Susan Jaffe, The Lancet’s Washington correspondent, reports.
“We will have tougher negotiation, more competition, and much lower prices at the pharmacy counter. And it will start to take effect very soon“, said President Donald Trump.
How soon will depend on what steps the administration takes on its own, through regulations and other mandates, and what changes can only be achieved through new laws enacted by Congress, which will increasingly be preoccupied by November’s election. [Continued here.]…
Besieged EPA Chief still committed to Trump agenda
Susan Jaffe | Washington Correspondent for The Lancet | 8th May 2018
At last count, at least four federal agencies were conducting nearly a dozen investigations of Environmental Protection Agency chief Scott Pruitt, probing his office renovations, a round-the-clock security unit who accompanied him on a trip to Disneyland, personnel management, and first-class air travel. The Capitol Hill condo he rented at a bargain rate of only $50 a night from the wife of an energy industry lobbyist has also come under scrutiny.
But in separate hearings held by the congressional subcommittees that oversee EPA, Pruitt dismissed the investigations as politically motivated.
“Those who attack the EPA and attack me are doing so because they want to attack and derail the president’s agenda and undermine this administration’s priorities,” Pruitt told the congressional panels two weeks ago. “I am simply not going to let that happen.”
…Republicans were eager to praise his achievements during the hearings, and encouraged him to keep at it. [Continued here] …
Scientists and physicians run for office in the USA
Volume 391, Number 10131
28 April 2018
WORLD REPORT Frustrated by what they say is the US Government’s disregard for science, more scientists and physicians are entering politics. Susan Jaffe, The Lancet’s Washington correspondent, reports.
Scientists, physicians, engineers, and their supporters surprised many people—and maybe themselves—when they assembled in cities across the USA a year ago demanding an end to President Donald Trump’s Administration’s so-called war on science, which has attacked climate change, environmental protection laws, and funds for biomedical research, among other targets.
But, for some critics, protests are not enough. Instead of appealing to elected officials, now they want to take their place.
“…More and more scientists realise that they have… an obligation to see that the idea of science is defended, that evidence is respected, and that the conditions for science to thrive are respected”, said Rush Holt, chief executive officer of the American Association for the Advancement of Science. [Continued here.] …
No barrier to CDC research on gun violence—except funding
Susan Jaffe | Washington Correspondent for The Lancet | 28th March 2018
A day after the horrific mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida on February 14, where 17 students and faculty were murdered and 14 injured, Health and Human Services Secretary Alex Azar fielded budget questions from a congressional committee. In response to Representative Kathy Castor, a Democrat from Tampa, Florida, Azar said there is no restriction on the ability of the Centers for Disease Control and Prevention (CDC) to conduct research into the causes of gun violence.
Questions about CDC’s ability to investigate gun violence—as it
would other public health threats—have persisted ever since Congress passed the 1996 Dickey Amendment prohibiting the use of research funds to advocate or promote gun control.
“We don’t believe that it gets in the way of our ability to do violence research or firearms violence research at any part of HHS,” Azar told another congressional panel a month later. “I think we’ve now made it quite publicly—and within the administration—clear that we don’t see any barriers around violence or firearm violence research. We’re in the evidence and science-gathering business.”
His assurances were also included in the instructions that accompanied the budget agreement Congress approved and President Donald Trump signed into law last week. While some observers believe this means CDC has permission from Congress to proceed, some leading experts in firearms research are skeptical. There may be no barriers, but they say there’s no funding either.[Continued here] …
CDC faces leadership changes, potential spending cuts
Volume 391, Number 10121
17 February 2018
WORLD REPORT The CDC has indicated it will reduce its foreign presence, and proposed budget cuts make some fear its core functions are threatened. Susan Jaffe, The Lancet’s Washington correspondent, reports.
“We don’t know what the next outbreak organism will be; we don’t know where it will come from, or when it will emerge”, [former CDC director Dr. Tom] Frieden said. “But we are 100% certain there will be a next one and if we are not better prepared than we were during Ebola, shame on us.” [Full article here.]
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