Fighting Vaccine Hesitancy

In 2019, tens of thousands of Americans took an unproven COVID treatment—hydroxychloroquine—because a persuasive politician convinced them of its merits. So often, the message is more important than the verity of the message. We need to keep this in mind if we want to overcome vaccine hesitancy.

I was reminded of the importance of good messengers when I was reading an excellent book by Diarmuid Jeffreys about the history of Aspirin. In his book, Jeffreys recounts that tens of thousands of English people refused to take a cousin of Hydroxychloroquine, a medicine called Quinine, even though it was a proven treatment for malaria. They avoided the drug simply because, as good Protestants, they would not ingest what was known at the time as “the Jesuit’s root.” Early advocates of the drug were Jesuits within the Catholic Church, and that didn’t go over well with the largely Protestant British population.

Then a clever, if not deceitful, apothecary persuaded people to accept the treatment. The story of this Protestant practitioner holds lessons for our current struggles to contain COVID-19.


To read the full article, please visit Forbes.

My Doctor Told Me The Cost Of The Appointment… Give Or Take $200!

I had a persistent skin condition, and my dermatologist thought I should see someone with more experience caring for that kind of lesion. So, I went to a new dermatologist, I will call her Dr. Freezeitoff. At the front desk, the clerk reminded me that Dr. Freezeitoff wasn’t in my insurance network, and therefore I’d have to pay for my visit out-of-pocket, as little as $180 and as much as $250, depending on the length of the visit.

Dr. Freezeitoff seemed capable, with some new ideas about how to treat my condition. The visit wasn’t very long, but it didn’t feel rushed either. She injected my lesion with a medication and then zapped it with liquid nitrogen, the injection and zapping adding maybe two minutes to the visit. I expected that meant I would come out on the higher end of the clerk’s estimate, probably $250 or so.

But I was charged more than $400. The difference in cost was all related to the three minutes of zapping. There is an idea, quite popular in health policy circles these days, that if we expose patients to higher out-of-pocket costs, they will respond as empowered consumers, demanding low cost, high quality medical care, thereby helping the country rein in soaring healthcare costs. My visit to this well-intentioned dermatologist illustrates one of the flaws of this idea of consumer empowerment.


To read full article, please visit Forbes.

Coverage That Kills – Breast Cancer Care Is Undermined By High Deductible Health Plans

There are so many awful things about breast cancer. Here are two of them. (1) Receiving a diagnosis when your cancer is already advanced; (2) Not having enough money to pay for your treatment. 


Here is an awful thing about high deductible health plans: They delay breast cancer diagnosis and get in the way of proper breast cancer care. 


We should all be bothered by high deductible health plans. For starters, the deductibles are often too high. For individual coverage, it’s increasingly common for people to face deductibles of $2,000 or more. For families, deductibles can exceed $6,000. To make matters worse, high deductible plans often burden people with other out-of-pocket. Add in these copays, and a family could face more than $13,000 of out of pocket expenses on top of their insurance premiums. 


To read full article, please visit Forbes.

Don’t Just Thank Science For Covid Vaccines

My Facebook feed is once again populated by images of people grateful for Covid vaccines, now that their young children have become eligible. Accompanying pictures of their children with colorful Band-Aids on their arms is typically a caption “thanking science” for developing the vaccine.


It is the season for expressing thanks. With that in mind, I’m here to urge us all to thank more than just science, or scientists, for developing these amazing vaccines. In fact, here is an incomplete list of other people and groups we should thank:


1. Science and Scientists: Although I am writing to urge us to not limit our thanks to scientists, I would be remiss not to thank them for their work. Many dedicated scientists have worked insane hours developing the vaccine. They deserve our, literally, undying gratitude.


2. Research volunteers: Scientists, on their own, did not prove that vaccines are effective against Covid. Instead, researchers conducted clinical trials in which tens of thousands of people voluntarily put themselves forward to help us all figure out whether the vaccines worked.


3. Pharma: Without for-profit companies willing to invest money in vaccine development, testing, and production, we would not have many shots in many arms.


To read full article, please visit Forbes.

There Is Nothing Wrong With Healthcare Profits

Elizabeth Warren says she’s “never met anyone who likes their health insurance company” and excoriates insurance companies for maximizing “their profits by saying ‘no’ to coverage.”  Best-selling author and healthcare journalist Elisabeth Rosenthal refers to insurance companies as “well-deserved villains,” joined in that ignominious category by pharmaceutical companies and hospitals, who have greedily jacked up their prices.


Undoubtedly, the US healthcare system is bedeviled by greed, with drug companies, device manufacturers, hospital organizations, physician groups, and insurers scrambling to grab hold of a slice of the more than $3 trillion we spend on medical care each year. At its extreme, such greed leads people like “pharma bro” Martin Shkreli to hike their prices 10-fold, 100-fold, or more, placing affordable medical care out of the reach of people who need it. But focusing our anger at greedy drug company executives or rapacious hospital CEOs is dangerous, seducing us into thinking that the problem with American healthcare is bad people or bad industries—making us think that, if we could shame CEO’s into submission or rid ourselves of the health insurance industry, our problems will be solved.


The problem with American healthcare is not the existence of greed. It’s the rules greedy people need to follow to make money. The key to reforming American healthcare is not to demonize greed, but to change the rules of healthcare reimbursement.


To read the full article, please visit Forbes.

Too Many Blood Pressure Pills—Here’s A Time When Treatments Go Too Far

You’re in the hospital with an acute illness. Perhaps your gallbladder is acting up, doubling you over with abdominal pain. While taking care of you and your gallbladder, the doctors noticed that your blood pressure is elevated. So they adjust your blood pressure medicines to bring it back down to normal. Everything seems hunky-dory.


But if you don’t get close and careful follow-up, those blood pressure pills could do more harm than good.


In a recent post, I showed how common it is for patients to receive antibiotics in the hospital even when those drugs will do more harm than good. Well here’s another harmful practice: adding new hypertension medications to patients whose blood pressures jump up during hospital stays.


To read the rest of this article, please visit Forbes.

Colon Cancer Plus American Health Insurance – A Fatal Combination

A quarter of employers now offer only high-deductible insurance plans to their employees, and another quarter are thinking of following suit. The US is rapidly becoming a high out-of-pocket healthcare system, often with disastrous results. Consider what happened to Chris Howard after he saw the water in his toilet bowl turn bright red. 

Howard (a pseudonym) figured it was probably from a hemorrhoid, but a colonoscopy test uncovered a Stage 3 cancer that had already begun invading the wall of his intestines. At the ripe young age of 38, Howard found himself face-to-face with a life-threatening illness. 

To read the rest of this article, please visit Forbes.