Sick to Debt Now Available as Audio Book

I’m excited to announce that my book is now available through Audible, to accompany you on all those long commutes you are no longer making to your job every day. Sigh…  But seriously, I think the topic of this book is more relevant than ever, and hope that having another way to “read” Sick to Debt will get more people engaged with these important ideas.

Link to Audible


Antibody Tests Could Offer A False Sense of Security

A lot of hope on reopening businesses and returning to work in the U.S. hinges on COVID-19 testing and the development of treatments and a vaccine.

But as the country ramps up antibody testing – analyzing blood samples for signs someone has been exposed to or infected with the coronavirus that causes COVID-19 – physician and economist Peter Ubel of Duke University’s Fuqua School of Business warned about the potential consequences of imperfect tests.

“Right now, there have been a lot of tests that have been approved by the FDA, but some are not so great,” he said. Many tests boast what may sound like low error rates, he said. Yet even seemingly small rates of false-positive and false-negative results could lead to people unwittingly spreading the virus, either thinking they are not infected and safe to socialize, or falsely believing they have already been exposed to the virus and can’t be infected again. Therefore, the idea that people could use testing to determine who’s immune and can return to a non-socially-distant life may not be realistic, he said.

“I think this idea of an ‘immunity passport’ is not ready for prime time, because I don’t think any test could be accurate enough to give us anything but a false sense of security,” Ubel said recently on a live broadcast for Fuqua followers on LinkedIn (see videos). He also co-authored an opinion piece in The Washington Post on the topic.

(To read the rest of the article, please visit Fuqua.)

‘Immunity passports’ could be doomed by false-positive antibody tests (Washington Post)

Antibody testing has accelerated in the United States in recent weeks: In one prominent study, for example, involving some 3,000 New Yorkers, roughly 14 percent of state residents were found to have been exposed to the virus — and 1 in 5 in New York City. Some proponents of such tests believe they could pave the way for “immunity passports,” documents identifying people who have previously been infected and may now be immune to the virus. They might allow people to rejoin the workforce, or eat in a restaurant.

Immunity passports are controversial for many reasons: We don’t know the extent to which exposure to the novel coronavirus protects against future infection, for example, and a passport system raises important issues involving medical privacy. (To present potential cheating, testing would have to be officially verified and, most likely, stored in a centralized database.) Passports could create perverse incentives for people in precarious economic circumstances to deliberately catch the disease so that — if they recover — they can return to normal life. They could rend social cohesion by splitting the population into groups with greater and fewer rights.


(To read the rest of the article, please see Washington Post).

Charging Copays and Deductibles During a Pandemic Is Foolish—and Deadly (Newsweek)

In areas of the country hardest hit by COVID-19, clinicians are already being forced to make tragic rationing decisions: about who to admit to the hospital, who to transfer to the ICU and who to place on scarce ventilators. These decisions feel out of character with our national identity. We normally think of ourselves as too wealthy, too committed to preserving American lives, to ration medical care.

However, rationing of American health care also takes place every day in subtler ways. We see that when a weekend tennis player with a sore shoulder decides to hold off on getting an MRI, or when a smoker with a touch of heartburn takes a few antacid tablets rather than schedule an appointment with her primary care physician. They delay care because their insurance companies require them to fork over copays and deductibles to cover the cost of these services, and they’ve decided that their money is better spent in other ways.

This may not sound like rationing on its face. But bear with me. Because when that “heartburn” turns out to be a heart attack, when that cough turns into a COVID-19 infection, delaying care to avoid out-of-pocket expenses can be deadly.

(To read the rest of the article, please visit Newsweek.)

This Is Not the Time to Worry About Paying for the Medical Care You Need

Here is a nice article by Dennis Thompson at HealthDay about the challenges people are going to face paying for medical care, especially if they’ve lost or been laid off from their jobs. I chime in at the end URGING people not to worry about money right now if they are sick. Get the care you need!

The coronavirus pandemic is spreading across the United States at the same time that millions have been laid off from their jobs.

That raises the obvious question — how will those newly unemployed folks pay for medical care if they become infected with the coronavirus?

Recent bills passed by Congress ensure that people won’t have to pay out of pocket for any COVID-19 testing, even if they’re uninsured, but there’s nothing that would cover treatment costs for people without insurance.

(To read the rest of the article, please visit HealthDay).


Expert: NC better positioned than other states to respond to pandemic (WRAL)

The slow growth in coronavirus cases in North Carolina relative to New York and some other states puts North Carolina in better position to respond to the pandemic, according to a Duke University professor.

Economist Mark McClellan, the director of the Duke-Margolis Center for Health Policy, was U.S. Food and Drug Administration commissioner during the SARS epidemic in 2003. He said North Carolina has a chance to get ahead of the new coronavirus if it acts quickly.

“I think North Carolina is a little bit lucky in that it’s not seeing as much of a rapid growth in cases as other, more urban, densely populated areas around the country are facing right now. That’s given the state the advantage of a little more time for preparation,” McClellan said Friday. “That’s not to say that those preparations should slow down. It just means that we’ve got more of an opportunity to make sure that the supplies – ventilators, hospital beds – [are in place] and also support for patients with milder illnesses so they don’t go to the hospital.”

(To read the rest of the article, please visit WRAL).

US government’s WWII mobilization on penicillin is a road map to fighting the coronavirus (USA Today)

On March 14, 1942, an American soldier with bacteria coursing through his bloodstream was treated with penicillin, a new wonder drug that saved his life. That single treatment exhausted half the nation’s supply of the drug. Two years later, as U.S. troops prepared to launch the D-Day invasion, America had more than 2 million doses of the drugready to use.

Donald Trump refers to himself as a wartime president. But he is reluctant to use the power of the federal government to meet the nation’s urgent needs, instead relying on private companies to ramp up production and distribution of medical equipment. He should look back to World War II. It wasn’t private industry on its own that overcame the shortage of penicillin. It was an ambitious effort coordinated and funded by the U.S. government.

The history of penicillin manufacturing during World War II teaches an important lesson: If we hope to address the shortage of lifesaving medical equipment, and if we want to make sure available equipment is distributed in a manner that saves the greatest number of lives, the U.S. government needs to take the lead.

(To read the rest of the article, please visit USA Today).

Here’s Why Good Food & Nutrition Is Essential For Health

The patient’s health was suffering because he couldn’t afford one of the cheapest, most effective medicines in the marketplace. He was coming back and forth to the Ann Arbor Veterans Affairs Medical Center for his care. His physician, an internal medicine trainee at the University of Michigan, tried everything in her power to help the patient, but his health kept declining. Then one morning, she entered the clinic room and saw him look back at her with a big grin on his face. He’d gained 10 pounds; he had more energy, and less depression. It was a medical miracle. How had it happened?

One of the faculty physicians supervising her in clinic had witnessed the patient’s decline and sent him money to buy the medicine he needed. That medicine was a mixture of protein, fat, and carbohydrates that typically goes by its generic name: food!

Despite the great wealth of our nation, millions of Americans suffer from food insecurity, uncertain they can afford enough food to meet basic caloric needs. Such insecurity can take a terrible physical toll, as the opening anecdote illustrates. But we don’t need to rely on anecdotes to picture the toll of food insecurity.

(To read the rest of the article, please visit Forbes).

There’s Still Only One Effective Treatment For Obesity, And It’s Life-Saving

Obesity kills. It leads to diseases like diabetes that, in turn, increase the risk of fatal cardiovascular diseases such as strokes and heart attacks. Wouldn’t it be nice to have a treatment that forestalled all this misery and mortality?

Unfortunately, many treatments don’t work well, either to combat obesity or to hold off its consequences. There are a slew of medicines that treat the consequences of obesity—sugar-lowering pills to control diabetes, antihypertensive pills to control blood pressure, cholesterol pills to… well, you get the idea. But there aren’t many good ways to combat the obesity at the center of these other problems.

Diets? They might work for a few months, but few people achieve sustained and significant weight loss through dieting.

(To read the rest of the article, please visit Forbes).