Belated Medical Monday

I have just heard the best news about the Republican plans to replace the ACA (Affordable Care Act). Senate Republicans would like to postpone a repeal until……drum roll please …. the year 2020, when, you guessed it… another presidential election will take place ! I think this may be the GOP’s way of saying, “Sorry, never mind. We agree with President Trump who said, “Health care is hard.”." 

Especially now that the piper has started talking about getting paid… i.e. the Congressional Budget Office (CBO) has had it’s say, lawmakers on both sides of the aisle have come to realize that the costs of dropping the ACA provisions may exceed the costs of keeping them. 

There is however a need for action, and Senate Republicans will likely try to take action to stabilize premium costs. They will also to endeavor to continue federal insurance subsidies which help low income American with co-pays and deductibles. 

In other policy news, the Mexico City policy is back in place. This is the policy of withdrawing US aid funds from international organizations which provide reproductive services which include abortion. This is policy is meant to show the current administration's condemnation of abortion, and to curtail the incidence of abortion. However, Kenyan health care researchers have cited clear evidence from the past about what happens when the Mexico City Policy is in place. In fact, if these US funds are withdrawn from these types of health clinics, then many women go without health care and contraception and many more unintended pregnancies occur. Not surprisingly, under these circumstances, MORE abortions are actually performed. It seems impossible that the administration cannot be unaware of this. If this is true then it would seem they are really more interested in political posturing than abortion prevention or the health care of women. I'm going to speculate this this exact sort of thing will happen in that other part of the third world called Texas, where women's health care services have been severely restricted.

The Mexico City rule is also called the “ global gag rule” since all US funds can be withheld even if the clinic staff even speak of abortion.

Did you know that the current administration proposes not only to cut coverage of health care but also to health care research ? In his 2018 budget request titled “ A New Foundation for American Greatness”, cuts are proposed for the FDA ( Food and Drug Administration), the CDC (Centers for Disease Control), and the National Institute of Health (NIH) including the National Cancer Institute. How do you feel about this ? Tell your elected officials. 

Many on the red (Republican) side of the aisle continue to favor covering those with pre-existing conditions. Many of you may know of Jimmy Kimmel, the late night host and comedian. He has entered the health care debate in a most poignant way. His wife recently gave birth to a son with a congenital health defect. This defect required immediate very expensive and live saving surgery, which with insurance under the current Affordable Care Act, will be covered entirely. This baby's care coverage will not be subject to penalties for preexisting conditions, and there are currently no caps on insurance payouts under the ACA. Cases like this do become very costly, and in an environment where there are caps on what an insurance will pay, the Kimmel child might not get all the care he needs to live. So, legislators have spoken of health care plans which “pass the Jimmy Kimmel test". To pass the test, an insurance plan must cover all the care that such a baby would require. Many Republicans are coming out to favor plans which pass the Jimmy Kimmel test. See Jimmy’s moving monologue HERE:

http://ux.azcentral.com/story/life/tv/2017/05/02/emotional-jimmy-kimmel-discusses-baby-sons-heart-surgery/101189324/

In medical news, ACOG is trying to get the word out on normal anatomy. There is a disturbing rise in cosmetic surgery for the female genitalia, even in young women.  ACOG (American College of Gynecologists) is trying to educate patients and clinicians about the considerable variation in normal anatomy. They are also cautioning against so-called vaginal rejuvenation surgeries and other procedures which can have serious complications. One has only to look at the high costs of such surgery and the lack of insurance coverage of it to know that it is simply a moneymaking ploy used by unscrupulous gynecologists. 

In the “ we already knew this” department, a new study has come out reiterating that domestic violence is more common in pregnancy. Everyone needs to be aware of this. 

In the "you have some control” department, new research indicates that even one 10 ounce alcoholic drink may increase your risk of breast cancer- by nearly 10 % in post menopausal women ! The same study also shows that vigorous exercise reduces the risk of breast cancer. Worried ? Stop drinking and start exercising. 

It has now been well established that the HPV vaccine works to prevent genital warts and reduce the incidence of cervical cancer. The new revelation is that for kids under 15, only two rather than three doses are needed. 

Do you snore ? If you do, go get evaluated, regardless of your age. It is clear that sleep apnea increases risk of cardiovascular disease. New research also indicates that it complicates pregnancy, increasing risks of gestational diabetes and preeclampsia. 

Bed sharing with newborns increases risk of SIDS ( Sudden Infant Death Syndrome). A new program which includes face to face education and distribution of baby box kits has been shown to be effective in reducing the incidence of bed sharing. Baby boxes provide a separate space for baby with a flat mattress and a firmly fitted sheet. These boxes, as opposed to a bed or crib with lots of blankets, toys and fluff, are much safer places for baby to sleep. 

 

Stay tuned for next week’s Medical Monday and thank you for your patience !