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The Most Overlooked Factor In Healthcare Reform: State versus Federal Regulation of Insurance

For months, Congress has been debating health care reform proposals that would have the effect of dealing a heavy blow to the system of state-by-state insurance regulation.  State governments have stood by, silently.  I’ve been wondering (here, here and here) when the states would start to raise objections.

Slowly, it’s starting to happen.  What has been a mostly overlooked factor in the health care reform debate may end up being one of the most important.

In fourteen states, legislators are trying to pass constitutional amendments that would ban health insurance mandates.  Meanwhile, a bi-partisan group of governors are objecting to provisions of the Baucus plan that would leave the cost of expanding Medicaid to the states (by contrast, the House bill provides federal money for this).  It’s an emerging trend that may reflect growing unease in state governments. Read more »

*This blog post was originally published at See First Blog*

Smoking May Worsen Multiple Sclerosis

When thinking of the health risks of smoking, almost everyone is aware that smoking causes lung cancer and respiratory diseases. The connection between inhaling smoke into the lungs and developing diseases of the lung is immediately plausible. But every year medical researchers discover more and more diseases that are worsened by smoking.

One example that recently caught my attention is multiple sclerosis (MS). MS is a very serious neurological condition caused partly by damage to the myelin sheath covering cells and their connections in the central nervous system. The precise neurological symptoms the person experiences depends largely on which part of their central nervous system is affected. Read more »

This post, Smoking May Worsen Multiple Sclerosis, was originally published on Healthine.com by Jonathan Foulds, Ph.D..

Personal Responsibility, Healthcare Reform, And Going With Our Guts

This post appears on the Hastings Center’s Values and Health Reform Connection, a new group blog on American values and why they matter in health reform.

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Values come from the gut, not the mind, and the gut is not a sophisticated thinker about the nuances of alternative policy options.

—Jim Sabin, MD Essay: Responsibility

I’m going to do something “radical” here in the spirit of Dr. Sabin’s opening quote – and speak from my gut on the topic of responsibility.

In my opinion, it’s human nature to shirk responsibility, and our current society is a great facilitator of that natural urge. The more wealthy and technologically comfortable we become, the fewer responsibilities we have (in terms of securing basic needs), and the more empowered we are to indulge our inner narcissism. Until we accept that we all have this selfish tendency, we’ll continue to point at others and engage in a blame game that keeps us all very much in the dark about what’s really going on. Read more »

Comparative Effectiveness Research Costs More Than Most Realize

I just finished our first day at the Principle Investigator Meeting for the launch of the Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial in Philadelphia today. The trial is a 3000-patient patient trial performed at 140 centers around the world and jointly sponsored by the National Heart, Lung, and Blood Institute (NHLBI), a component of the National Institutes of Health (NIH), and industry (St. Jude Medical and Biosense Webster).

The trial will randomize 3000 previously untreated or incompletely treated patients at high risk of cardiovascular complications in the trial to two arms: 1500 patients to catheter ablation as primary therapy of atrial fibrillation and the other 1500 patients to conventional medical therapy with rate control or rhythm control strategies to determine if catheter ablation is superior to medical therapy at reducing total mortality (the primary endpoint). Secondary endpoints of a composite endpoint of mortality, disabling stroke, serious bleeding, or cardiac arrest will also be studied.

If done properly, this study stands to be a landmark trial for the field of cardiac electrophysiology and has huge ramifications for the treatment of patients with atrial fibrillation. Also, it doesn’t take a lot of rocket science to know that the government will be looking closely at the results of this trial to determine which treatment strategy will receive government funding. Read more »

*This blog post was originally published at Dr. Wes*

Bee Venom Nanoparticles Can Kill Cancer Cells

We have known for many years that melittin, an ingredient in bee venom, is a poison to tumor cells. Development of therapeutic uses of the substance has been stymied by the fact that melittin does damage to healthy cells as well. Now researchers from Washington University in St. Louis have developed nanoparticles called “nanobees” that can ferry the melittin directly to tumor cells with great specificity.

The Wall Street Journal reports: Read more »

*This blog post was originally published at Medgadget*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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