Medical Monday: Delayed Edition

After I got my diagnostics squared away, I discovered ACOG’s ( American College of Obstetrics and Gynecology) news site was down. Members like me have access to their news and research paper aggregator. I use it as my starting point for creating your news digest blog post page Medical Monday. Finally, all is well and we have some catching up to do. 

GOP leaders have once again announced a deadline for a vote on their health care plan, the American Health Care Act (ACHA). The deadline is to be the end of June. However, as of this writing, there are still significant disagreements over the particulars. Moreover, the drafting of the bill has now gone behind closed doors. This has met with consternation not only from Democrats but from Republicans too, since such interested stake holders cannot have a say or even see what is going on. 

The Department of Health and Human Services, (HHS) has a nonpartisan economic unit called The Office of the Actuary. According to a recent analysis done by this office, adoption of the ACHA would cause out of pocket expenses to rise about 61%. This means premiums and deductibles would rise 61% for the consumer. While the real cost of the premiums would be somewhat lower, the government subsidies to defray them would diminish, leaving the consumer to pay the difference. The current administration wants to pay less, and wants we consumers to pay more. Remember that the government’s money is really our money, collected in the form of our tax dollars. While about 29% of the American public supports the ACHA, it is not formally supported by a single State government. This is because the Fed is trying to do to States what it is doing to us. It is trying to shift more of the financial cost of health care off of itself and onto the States. If the current administration succeeds in shifting health care costs to the consumer and the States, it will claim it is saving taxpayer money.

Many of you are already aware that Texas is facing a crisis in maternal morbidity and mortality. Concern is mounting that the crisis will only get worse if the ACHA is passed, since it will reduce already limited funds for the care of women and pregnant women. 

Business leaders are starting to register concern about the looming changes in health care. In particular, the cancellation of the contraceptive benefit is projected to have huge economic and social repercussions for American families, such as spikes in unplanned pregnancies, and ripple effects though the workplace. A statement by Allan Peace of Trillium Asset Management notes that “ institutional investors… see compelling evidence that widespread access to sexual and reproductive health care benefits” promotes  the “interrelated outcomes” of women having greater control over their lives and the facilitation of economic growth. I would add that this has been demonstrated not only domestically, but around the world. Yes, prosperity and the status of women are directly related. 

In the good news department, Maine is the next in a line of States taking matters into their own hands. They have passed legislation requiring insurers to pay for up to 12 months of birth control at a time, and have prohibited insurers from charging copays for birth control. They cited data from California indicating that the unintended pregnancy rate fell by 30% when they enacted similar measures. Twenty eight states now have some sort of contraceptive equity law, aiming to make contraception very affordable or free. Let’s hope we get 50. 

The Royal College of General Practitioners has presented research again confirming that oral contraceptive use does not confer increased long term cancer risk. 

In further good news, the City of San Francisco has spelled out clearer rights for breastfeeding women in the workplace. This includes the stipulation that employers provide a clean private space with electricity, a surface and a chair. 

In medical news, Zika is back. Zika is a virus carried by the Aedes Aegyptae mosquito found from the southern US southward. When contracted by pregnant women, it causes serious malformations in the nervous systems of developing babies. 1900 women in the US have had confirmed Zika infections. The proposed White House budget proposes an emergency fund for Zika but would also cut billions from budgets of the National Institute of Allergy and Infectious Disease and the CDC (Centers for Disease Control) where work is underway on a vaccine. The first cases of the 2017 Zika season have come in from … Texas. 

A new study confirms from JAMA Pediatrics indicates that even small amounts of alcohol in pregnancy may result in babies with slight facial abnormalities. 

Obesity (BMI of 30 or more) is a huge problem. However being overweight (BMI 25-29) takes its toll as well. New research published in the New England Journal of Medicine indicates that, worldwide,10% of people are overweight. Altogether 30 % of the world are affected by weight problems. The US leads the world in obesity in children and young adults. The US also has the greatest number of obese adults. Excess weight accounts for 4 million deaths worldwide, seventy percent of which are from cardiovascular disease. 

A new and large study from Sweden indicates that the risk of major birth defects increases proportional to the severity of a mother’s obesity. These patients are also at greatly increased risk of hypertension ( high blood pressure ) and diabetes. 

That gets us up to date with the news from the world of Obstetrics and Gynecology.