Time To Ban Kid-Friendly Flavors For E-Cigarettes

Cinnamon. Buttered popcorn. Strawberry and banana. Yummy tastes and smells that have lingered in my TV room, after my teenage son and his friends finish vaping. E-cigarette companies like Juul are creating flavors designed to lure young customers, following a tradition established by their cigarette-manufacturing predecessors. For a while, the Trump administration appeared poised to ban all flavored e-cigarrettes. Later this fall, after intense lobbying and after fretting over the possibility that such a ban would harm his re-election chances, the President backed off . Now, word comes out of the White House that the ban is back on, this time carving out exceptions for menthol and tobacco flavors . This is an important and wise move.  All these candy-like flavors need to be banned. There is no public health justification for allowing companies to hook adolescents on their addictive products.

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



Here’s How Tripling Prices Could Save You 40% On Your Medications

Medication prices in the US have gone from wild to insane; from expensive to outright unaffordable. But a tripling in prices could save us all a lot of money. Here’s how that would work.

It’s a policy known as external reference pricing. The idea is simple. First, the US government would look at how much a drug company charges for a given medication in a handful of other developed countries. Next, it would tie the US price to some multiple of that international price.

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

Show ‘Em the Money: Paying Patients to Shop for Affordable Medical Care

After three months of physical therapy, her doctor told her that it was time to get an MRI. She had already paid off her annual deductible, meaning the imaging test would “only” cost her the $150 co-pay. An imaging center near where she worked charged $1500 for the test. Just two miles away, another facility would have just charged only $900 for the same test. She arranged to go to the more convenient location knowing the difference in price would be picked up by her insurance company.


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

An $800 Head Cold? Time to Fight for Price Transparency in American Healthcare

Jay Singh had a nasty head cold. Not a “will-I-survive-this-plague” kind of infection, but also not one he thought, if left to its own devices, would blow over in a day or two. So he went to the primary care clinic near his exurban New York City home. The doctor spent ten minutes examining and talking to Singh (a pseudonym), a quick look at his throat, a cursory listen to his lungs. The doctor ordered a routine “respiratory viral panel” and prescribed a cough suppressant. Singh had already anted up a co-pay for the office visit, but a few weeks later he received a bill for the services rendered: $800 to cover his doctor’s time and the cost of the viral panel.

I spoke to Singh several months after his appointment, and he was still determined to leverage his experience into political action: he thinks it’s time for the state of New York, perhaps the whole U.S., to bring healthcare prices out of the dark so patients like him can make informed decisions about their medical care.

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

It’s Time For Health Insurance To Pay For Dental Care

Last time I checked, the mouth was still part of the human body. If I remember correctly, when people experience mouth problems, they ache just as much (often more) than if they experienced problems elsewhere in their bodies. So why do we still treat care of the mouth differently than other types of medical care? Why will my health insurer reimburse the cost of my annual physical but not the price of an annual dental check-up?

The insanity has to stop.

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

An Author’s Musings On Writing A Book

I have a book a coming out this fall. The book took many hours to write, with discarded chapters littering my Dropbox folder. My initial book proposal was rejected by every publisher I sent it to. After the withering critiques, I rethought the project and managed to convince the folks at Yale University Press to publish it. Sick to Debt will arrive in bookstores in November.

Why in God’s good name did I spend so much time writing a book, in a world increasingly focused on 280-character tweets and 700-word blog posts?

I’ve pondered this question for many years. In fact, I recently came across an essay I wrote in 2000, when my first book, Pricing Life, came out. Back then, Twitter and Facebook weren’t yet pulling people away from long-form writing. But I was still worried about the marketplace for books, in ways that show how quickly the world has changed. Here’s what I wrote back then:

Why waste time writing a book? The dominance of bookstore chains and Oprah have made it increasingly difficult for most authors to get their books in front of their target audience. Worse yet, people have less time to read books than they used to—cable TV channels multiply faster than the flick of a remote control button, while traffic jams suck away our remaining free time.

Oprah’s Book Club? Bookstore chains? If only authors could be so lucky today.

And yet here we are, two decades later, and I’m publishing my fifth book (and have already begun writing my sixth). If some of my earlier books had been best-sellers, my behavior would make rational sense. Atul Gawande would be stupid not to write more books. Me, on the other hand? In the time I write one non-best-selling book, I could write a dozen or more essays for leading journals, pushing out ideas to shape the intellectual landscape. Or I could write a couple more grants, securing funds to expand my research program. Heck, I could kick back and relax on Saturday and Sunday mornings rather than hunch over chapters that need major overhauls.

But I persist. I laid out a major reason for my persistence in that essay two decades ago:

But the truth is, I had plenty of selfish reasons for writing a book. It wasn’t for the money. It wasn’t for the fame. And it was not to increase my chances of being promoted! I wrote a book to consolidate my thinking about healthcare rationing. I had conducted a series of studies and published them in many medical journals. Writing a book allowed me to pull my research together, and place it into a broader context. In this regard, I wrote the book for the same reason I play piano every night—because it makes me happy.

There’s an even more important reason I write books. I think it is critical for us, as citizens, to intellectually grapple with the most important challenges of our time. Few things are more critical to democracy than an informed electorate. And some topics are best understood with deeper dives, certainly deeper than can be accommodated in an op-ed or Twitter “conversation.”

I wrote Sick to Debt because I think many Americans are fed up with the way our healthcare system increasingly shifts costs in their direction. I wanted to lay out the reasons, even the rationale, for such cost shifting. And most importantly, I wanted to show that there are better ways to tackle high healthcare costs than to pass them on to patients.

I hope to inspire people to push for changes in the way Americans pay for medical care. That’s why I wrote the book. That’s why I hope you read it.

Here’s Why Pharmaceutical Companies Raise Their Prices So Much

Yes, I’ve ranted about healthcare prices before. On more than one occasion. But I have a new rant for you.

  • It’s not about the high price of new drugs
  • It’s not about a couple pharmo-bro CEOs hiking prices of generic medications by 4 or 5,000%

It’s about brand name drugs already on the market, that, instead of getting less expensive over time (due to increased competition, say, or increasing efficacy of production) get more expensive.

A team out of the University of Pittsburgh tracked the costs of drugs between 2008 and 2016, and discovered some truly disturbing trends.

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

When An American Teenager Dies There’s a 1 in 5 Chance It Was From A Gunshot Wound

As a father of two adolescent boys, I think often about the risks they face. I just came across a terrifying statistic that will haunt me: a huge proportion of deaths among adolescents occur as a result of firearms.

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

Why Antibiotics May Do More Harm Than Good For People With Bacteria In The Urine

Many of us have been told that urine is normally sterile, meaning that if bacteria show up in, say, a routine urine test, there must be something wrong—we need to get rid of those bacteria. But as it turns out, in many people with asymptomatic bacteriuria—people who have bacteria in their urine but no symptoms of a bladder or kidney infection—antibiotics can do more harm than good .

Confused? Skeptical? Let me explain.

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

Why People With MS Need Permission from Insurers To Take Life-Saving Drugs. It’s Not The Reason You Think.

Multiple sclerosis (MS) is the number one cause of non-traumatic disability among young adults. MS is a chronic, incurable illness that destroys some of the body’s most basic neurological functions. Fortunately, there are now a slew of amazing medicines that often slow the disease considerably. These medicines can be the difference between whether or not a person spends her forties in a wheelchair.

Yet, insurance companies are increasingly requiring patients (or their physicians) to ask permission, known as pre-authorization, before the companies agree to pay for these critical medications.

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