Politics

What are the lawmakers, and other state and federal officials, up to when it comes to health reform laws?

RECENT POSTS

Opinion: Pending Mass. Paid Leave Bill Targets An Issue Of ‘Human Dignity Violated’

Author Kate Mitchell with her newborn son, Mateo (Courtesy)

Author Kate Mitchell with her newborn son, Mateo (Courtesy)

Ten days after giving birth to my son, Mateo, I was able to walk, but not much more than a few careful steps from couch to bathroom.

I was still bleeding. I was fighting mastitis, a breast infection that delivered a high fever and the worst chills I have ever experienced. Did I mention I was breastfeeding nearly every 45 minutes around the clock? I was totally in love, and completely exhausted.

Luckily for me, I didn’t have to go back to work right after Mateo’s birth. But the same is not true for far too many American women. In fact, about one quarter of mothers in the United States have no choice but to return to work within 10 days of having a baby — many of them still bleeding, still trying to establish breastfeeding, completely exhausted, and often traumatized by leaving their newborns at a time when they need their mothers most.

“At times I feel deeply disappointed that I couldn’t manage to fight harder for what every mother, including me, deserves: time and space to heal and to bond with her new baby.”

– Katey Zeh

In an effort to learn more about the issue, I put together an informal survey that I shared on Facebook and Twitter. One respondent, Katey Zeh, a maternal health advocate with the United Methodist Church, shared her story of lacking access to family leave: In 2014, she gave birth on a Monday, returned to work emails on a Friday, and fully returned to work the following Monday.

Paid parental leave is “partially about economic justice, but it’s also about my parenting — and my family — being affirmed by our society,” Zeh said. In a blog post, she describes in a bit more detail what the lack of leave meant to her:

Now that my daughter is six months old I look back on that time with a lot of regret. If I couldn’t advocate for myself, what kind of advocate was I anyway? If I couldn’t advocate for my kid, what kind of mother did that make me? At times I feel deeply disappointed that I couldn’t manage to fight harder for what every mother, including me, deserves: time and space to heal and to bond with her new baby.

Another respondent, a Catholic school teacher from Ohio who asked that her name not be published, said she loved her work but knew she would not be ready to return to its long hours only four weeks after giving birth — the amount of partial pay leave her employer offered. She also knew that her husband’s work would not allow him to share the home responsibilities, as his job required even longer hours and offered no paternity leave benefits. She left the job she loved. Continue reading

Policies For Transgender High School Athletes Vary From State To State

Justin Bonoyer stands in the athletic fields at Ponaganset High School in North Scituate, Rhode Island. Justin was Elise to his coaches until a few weeks ago. (Jesse Costa/WBUR)

Justin Bonoyer stands in the athletic fields at Ponaganset High School in North Scituate, Rhode Island. Justin was Elise to his coaches until a few weeks ago. (Jesse Costa/WBUR)

Crack. A bright pink aluminum bat connects with a fluorescent yellow softball, sending it toward woods that border Ponaganset High School in northwest Rhode Island. The left fielder runs in and makes the catch.

“Two down ladies, two down,” a player calls.

This is home field for Ponaganset’s Lady Chieftains, except, it seems, the team is not all ladies.

Justin Bonoyer, a stocky 5-foot-5-inch player with a shock of blonde hair, plays right field. Justin was Elise to his coaches until a few weeks ago, although he’d already come out as transgender to most of his teammates.

“I’m a guy,” Justin says. “It’s the same as if a guy who’s not trans went and played on a girl’s softball team.”

Well, sort of. There are separate rules for transgender athletes. Rules so different from state to state that some high school athletes like Justin can try out for any team they choose while others need sex reassignment surgery before they can sign up.

There’s a lot of attention on bathrooms in the debate about transgender rights. The next battleground may be locker rooms, basketball courts and soccer fields. For high school students, the debate centers on Title IX, the federal law that bans discrimination based on gender. Does it also ban discrimination based on gender identity?

We’ll lay out the arguments in a minute. First, a little more about Justin. Continue reading

Sudders: Combating Mass. Opioid Crisis ‘Is Going To Take Us Time,’ Even With New Law

Secretary of Health and Human Services Marylou Sudders speaks about the opioids legislation signed into law just moments earlier by Gov. Charlie Baker on Monday. (Jesse Costa/WBUR)

Secretary of Health and Human Services Marylou Sudders speaks about the opioids legislation signed into law just moments earlier by Gov. Charlie Baker on Monday. (Jesse Costa/WBUR)

A new law designed to stem the deadly opioid drug abuse crisis in Massachusetts was signed into law Monday by Gov. Charlie Baker. On Tuesday, the governor will also meet with his opioid working group to discuss implementing the new law.

Massachusetts Health and Human Services Secretary Mary Lou Sudders is part of that group and joined Morning Edition to discuss the new law. Continue reading

Related:

Baker Signs Compromise Opioid Bill Into Law

Surrounded by lawmakers and health and public safety officials, Gov. Charlie Baker signs the opioid bill into law on Monday at the State House. (Jesse Costa/WBUR)

Surrounded by lawmakers and health and public safety officials, Gov. Charlie Baker signs the opioid bill into law on Monday at the State House. (Jesse Costa/WBUR)

Massachusetts Gov. Charlie Baker has signed into law a compromise bill that seeks to alleviate the state’s opioid crisis.

The Republican governor signed the legislation Monday morning at the State House, surrounded by a bipartisan group of lawmakers and various health and public safety officials. The Democratic-led state House and Senate both unanimously passed the measure last week.

The bill includes a seven-day limit on first-time opioid prescriptions, new efforts to evaluate patients within 24 hours after an overdose and addiction screening for middle and high school students.

“This is a very important day here in the commonwealth of [Massachusetts]. Today, I just signed the most comprehensive measure in the country to combat opioid addiction,” Baker said to applause from the audience.

The governor delivered an emotional speech following the signing, choking back tears as he spoke about the stories he’d been told by those affected by the state’s opioid addiction epidemic. Continue reading

Related:

Ballot Initiative Seeks To Limit Cost Ranges For Medical Care At Mass. Hospitals

In Massachusetts, it can cost you or your insurance company two or three times more to deliver a baby at one of the big Boston teaching hospitals than at small- or medium-size facilities outside the city.

Is this a problem? Should the state try to fix it? That’s what you may have to decide when you vote in the fall. WBUR’s Martha Bebinger explains the issue for Morning Edition.

Related:

Compromise Opioid Bill Caps First-Time Prescriptions At 7 Days

Update March 9 at 3 p.m.: The House has unanimously passed the compromise bill (PDF). The Senate is expected to take it up Thursday.

Our original story:

BOSTON — A Massachusetts House and Senate compromise bill on how to tackle the state’s opioid epidemic includes new limits on first-time opioid prescriptions, a push to evaluate patients after an overdose and addiction screening for middle and high school students.

The provisions are not as dramatic as those proposed by Gov. Charlie Baker, but a spokeswoman said the Legislature is taking a strong step in the right direction.

Baker ignited controversy last fall when he proposed a three-day limit on first-time opioid prescriptions. The House took a step back and suggested seven days, and seven is the number in the compromise bill House members are expected to vote on Wednesday.

Liz Malia, chair of the House Mental Health and Substance Abuse Committee, said this restriction, coupled with the expectation that doctors and dentists will talk to patients about the dangers of addiction, will shift the thinking about opioids.

“We’re changing some of the culture, and in my mind that’s of the things that really has needed to to happen,” she said.

The seven-day limit includes an exception for adults with chronic pain. It has the support of the Massachusetts Medical and Dental societies.

“I think seven days is a lot more reasonable than the original three days,” said David Lustbader, an oral surgeon who is also vice president of the dental society. “That generally is enough time to get people through the acute period of pain, post surgically.”

Continue reading

Related:

U.S. Health Care Is Less Private, More ‘Socialist’ Than You Might Think

The extent of the government's role in health care has become a key issue in the Democratic presidential primary. Here, candidates Hillary Clinton and Bernie Sanders are seen in a debate on Jan. 17 in Charleston, S.C. (Mic Smith/AP)

The extent of the government’s role in health care has become a key issue in the Democratic presidential primary. Here, candidates Hillary Clinton and Bernie Sanders are seen in a debate on Jan. 17. (Mic Smith/AP)

By Richard Knox

Readers, a pop quiz:

The proportion of U.S. health care paid by tax funds is (a) less than 30 percent, (b) about half or (c) more than 60 percent.

If you picked “more than 60 percent,” you’re right — but you’re also pretty unusual.

“Many perceive that the U.S. health care financing system is predominantly private, in contrast to the universal tax-funded health care systems in nations such as Canada, France or the United Kingdom,” David Himmelstein and Steffie Woolhandler write in a new analysis of U.S. health spending in the American Journal of Public Health.

They find that 64.3 percent of U.S. health expenditures are government-financed. And they project the tax-supported proportion will rise to 67.1 percent over the coming decade as the baby boom generation ages and retires — nearly as high as Canada’s 70 percent.

“We are actually paying for a national health program, we’re just not getting it,” Woolhandler says.

tax dollars for U.S. health spending

Now, Himmelstein and Woolhandler have an agenda. For decades, they’ve been perhaps the leading researchers promoting the kind of single-payer health system that Socialist and Democratic presidential candidate Bernie Sanders has put on the debate agenda. One recent poll suggests more than half of Americans (and 30 percent of Republicans) support the idea.

But even if you disagree with the Himmelstein-Woolhandler ideology, their research is generally regarded as sound, and their method is straightforward.

They added up what federal and state governments spend on health through Medicare, Medicaid, the Veterans Health Administration, government employees’ health care premiums, tax subsidies and other programs. They argue that accounting by government agencies (the Center for Medicare and Medicaid) undercounts the real tax burden because it leaves out major pieces of the pie — such as government employees’ care ($156 billion a year) and tax subsidies for private, employer-sponsored coverage (nearly $300 billion).

And whatever you think about Medicare-for-all, it’s a good idea to see the present U.S. health care system for what it is — an increasingly government-funded financing scheme. Continue reading

Mass. House Approves Bill Aimed At Combating Opioid Overdoses

Massachusetts House lawmakers have approved a bill aimed at addressing the state’s alarming spike in opioid overdoses and deaths, while rejecting a proposal that would have allowed doctors to involuntarily commit those suffering from overdoses to drug treatment facilities for up to three days.

The bill, which passed Wednesday on a unanimous vote, would limit initial opiate painkiller prescriptions to a seven-day supply and set an evaluation requirement within 24 hours for overdose victims seeking help at hospital emergency rooms.

State Rep. Jeffrey Sanchez said there has been a change in the public perception that no longer sees individuals struggling with opioid addiction as “junkies” and “crackheads” but rather as individuals with an illness who need help.

“With this bill, we’re trying to help people not get to the lowest of their low and never reach that trap door,” said Sanchez, a Boston Democrat and House chairman of the Joint Committee on Health Care Financing.

The House bill has significant differences from a bill filed by Republican Gov. Charlie Baker.

Continue reading

Related:

Opinion: What A Cancer Cure ‘Moon Shot’ Might Look Like

During his final State of the Union address, President Obama announced a new national effort to cure cancer. He said Vice President Joe Biden, who lost his 46-year-old son to cancer last year, would lead the effort. (Evan Vucci/AP)

During his final State of the Union address, President Obama announced a new national effort to cure cancer. He said Vice President Joe Biden, who lost his 46-year-old son to cancer last year, would lead the initiative. (Evan Vucci/AP)

In his final State of the Union address Tuesday night, President Obama called for a historic new effort to find a cure for cancer, a “moon shot.”  

“For the loved ones we’ve all lost, for the family we can still save, let’s make America the country that cures cancer once and for all,” Obama said in naming Vice President Joe Biden to lead the effort. 

So what might such a massive endeavor look like? Here, Barrett Rollins, M.D., Ph.D., chief scientific officer at the Dana-Farber Cancer Institute, offers his vision:

President Obama’s call for a new national effort against cancer — a “moon shot” — comes at a most opportune time. Cancer research has advanced significantly and now genomic analysis of tumors can reveal the specific DNA changes that drive cancer growth.

Our patients at Dana-Farber/Brigham and Women’s Cancer Center and Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, through the Profile research project, are benefiting from this — using the powerful technique of next-generation sequencing, scanning more than 300 cancer-related genes in every patient’s tumor to look for abnormalities. In a growing number of cases, the DNA changes can be targeted by precision therapies such as designer drugs that block overactive growth pathways. Often it will take combinations of targeted drugs to halt cancer progression, and many studies of these combinations are underway.

At the same time, there’s enormous promise in the field of immunotherapy. We’ve learned how to boost the body’s natural defenses against cancer and how to remove the molecular “brakes” that cancer cells exploit to hide from immune soldier cells and hinder their attack on tumors. Drugs that help the immune system fight cancer are coming quickly to the market, and there is promising research on related strategies such as cancer vaccines and genetic manipulation of immune cells to recognize cancer cells in the body. Continue reading

Opinion: American-Muslim Doctor Reflects On Bigotry At Some Top Hospitals, And Beyond

By Altaf Saadi, M.D.
Guest Contributor

Recently, the wife of a prominent Boston businessman — one of my many wealthy, white patients at Massachusetts General Hospital — greeted me this way: “So what foreign medical school did you go to anyway?”

For background, I’m a petite, Middle Eastern young woman with a headscarf, and I’m guessing I do not resemble her vision of what a doctor “should” look like. That image is probably taller, whiter, male and not Muslim.

My answer (in perfect, unaccented English) to her question about where I was trained? “Harvard Medical School.” After that, her lips remained pursed shut for the rest of our encounter.

As the daughter of Iraqi and Iranian immigrants, such interactions unfortunately have been common for me and my family members since we moved to America weeks before 9/11. When former President Bush declared war on Iraq the following year, for example, my sister and I heard classmates scream, “Go back to your country!” from their pickup truck on our walk home from high school.

I thought that attending college and medical school at Yale and Harvard, respectively, would be my golden ticket to America’s meritocratic dream, that my prestigious diplomas would shield me from future experiences with racism and bigotry. As a neurology medical resident in “liberal” Boston, (and working at a hospital ranked No. 1 by U.S. News & World Report) I also thought that I would be judged based on my medical acumen, not by the color of my skin or the scarf I wear on my head. But I was wrong.

Dr. Altaf Saadi (Courtesy of the author)

Dr. Altaf Saadi (Courtesy of the author)

Another time in the hospital, a male patient told me that his religion is superior to mine. While I was listening to his lungs to help in the management of his shortness of breath, he added, “Why do you wear that thing on your head anyway?” Despite his abrasive behavior, I politely informed him of his treatment plan and told him that I am praying for his speedy recovery.

Another day,  an 80-year old patient with dementia began hitting me on the head when I checked in on her for my daily visit. Pointing to my headscarf, she said, “I don’t want someone with that taking care of me.” Despite her mental condition, the racism still stung as I continued to strive to provide her the best care possible.

My experiences are not isolated. A recent study in the American Journal of Bioethics found that 24 percent of Muslim physicians have experienced religious discrimination in the workplace.

This election year has made it harder to be a Muslim in America. Republican front-runner Donald Trump has advocated for registering Muslims inside the United States and banning those of us who reside abroad. Unfortunately, the majority of Republican Party members agree with him and the number of hate crimes against Muslims have tripled in recent weeks. Yet, I also recognize that Muslims are just America’s newest “outsiders.” Throughout our history, Catholics, Irish, Italians, women, African-Americans, Jews, Latinos and gays have all been targets of nativist fear-mongering. Many of these groups still face significant prejudice today, and hospitals are not immune from such discrimination, whether implicit or explicit.

When I was a third-year medical student, it appeared to me that the pediatric residents and attending physicians would spend extra time caring for the white infants and children during morning rounds. The two African-American babies and one Arab infant admitted to the inpatient pediatrics service at the time were never “oohed and aahed” at and received noticeably less attention. “Have you noticed that only the white children are called ‘cute’?” I asked my friend after our third day on the pediatrics rotation. My friend, an African-American medical student, had his own grievance. He had overheard a doctor refer to an African-American father as an “angry black man.” “I don’t understand,” my friend said. “His daughter is dying, he is upset, and has questions. He’s not asking any more questions than the other parents.”

Our observations were also not isolated incidents. Multiple peer-reviewed studies have shown that physicians unconsciously prefer and spend more time with white patients than African-American ones.

I also recall the occasional episode of overt racism in the hospital. One surgeon — prominent and stern in his crisp white coat — said the following about a Hispanic patient who was coming to have her melanoma examined for excision: “I can’t believe these people! They have been here for a decade, can’t bother to learn English, and we’re stuck waiting for an interpreter.”

But the episodes of implicit racism have been more commonplace. Continue reading