Hashtags of the Week (HOTW): Ethics and Politics (Week of February 11, 2013)

This week was packed with news stories and events that have implications for health care, research, funding, and science writing.  Tuesday sparked two major discussions on Twitter.  The first was regarding the speech given by Jonah Lehrer (former journalist at The New Yorker and science writer) at a media learning seminar for which he was paid $20,000 by the Knight Foundation.  As explained by Scientific American, this speech was expected to be a sincere apology and explanation of his actions after being caught plagiarizing and fabricating quotes in his writing both at The New Yorker and in his books.  Instead, the disgraced journalist proceeded to explain his actions in terms such as, “For some cognitive biases, being smart, having a high IQ, can make you more vulnerable to them.”  Understandably, science writers took umbrage and started the hashtag #worth20K to highlight science writing and journalistic efforts worthy of being paid $20,000.

This brought up questions of professional ethics, and another hashtag that comes up when science and health collide #bioethics.

The second major news event of Tuesday was the State of the Union (SOTU) Address.  The importance of funding science and research initiatives was highlighted in the President’s speech and Twitter took a closer look at those issues.  These tweets came from a variety of tags including #SOTU and #science.

Part of the conversation around SOTU focused on the Affordable Care Act and peeking out were some health and technology issues that showed up in #HealthIT.

On the topic of health and technology, is this weekend’s #TEDxManhattan.  TEDx are independently organized Technology, Education, and Design conferences based on the same format as the original TED conferences.  The topic for this particular conference is “Changing the Way We Eat.”  TEDxManhattan will be streamed via the internet, and live tweeted via the #TEDxManhattan and #TEDxMan hashtags.

And if you want to chat about sustainable foods a little closer to home:

A year-end Affordable Care Act litigation round-up

From the Health Affairs Blog:

Undoubtedly the biggest health reform news of 2012 was the June 28 decision of the United States Supreme Court narrowly upholding the Affordable Care Act’s individual responsibility provision as a constitutional exercise of Congress’ power to tax. The Court also held that Congress lacked authority under the spending clause to require the states to extend Medicaid coverage to all adult citizens with incomes under 138 percent of the federal poverty level, although it upheld the Medicaid expansion as an option.

The Supreme Court decision brought to a close most of the approximately thirty cases that had been filed challenging the individual responsibility provision and other provisions of the ACA.  Some of these cases, however, have died a lingering death.  On December 19, 2912, a federal court in Arizonadismissed the final remaining claims in Coons v. Geithner, a case brought by, among others, Senator Jeff Flake.  The court held that the ACA preempted Arizona’s Health Care Freedom Act and did not violate any rights of the plaintiffs to medical autonomy or informational privacy.

Another case has flickered back to life.  As reported earlier, the Supreme Court on November 26, 2012, vacated its earlier order denying review of a challenge brought by Liberty University to the ACA and sent the case back to the Fourth Circuit Court of Appeals for further consideration.  The Fourth Circuit’s earlier decision against Liberty University was set aside by the Supreme Court strictly based on that court’s conclusions as to jurisdiction, and the only outstanding issue in the Supreme Court appeal — the constitutionality of the employer responsibility provision — has no chance of succeeding given the well-settled power of Congress to legislate concerning employee benefits.  Liberty University is likely, however, to also press religious liberty challenges to the ACA that it raised in its original complaint, and these challenges may require further consideration.

Read the complete post on the blog web site.


FAQ: Decoding The $716 billion in Medicare reductions

From Kaiser Health News:

The structure and financing of Medicare, the federal health insurance program that serves seniors and the disabled, has become a defining issue in the presidential and congressional campaigns since GOP presidential candidate Mitt Romney picked as his running mate Rep. Paul Ryan. KHN’s Mary Agnes Carey answers some frequently asked questions about the numbers and policy surrounding the Medicare debate.

 Q:  Romney and other Republicans over the past two years have criticized President Barack Obama and Democrats for cutting $500 billion from the Medicare program over the next decade as part of the 2010 health care law.  In the past couple of weeks, the number that Romney is using has grown to $716 billion? Which is right?

A: They both are.  The $500 billion figure comes from a March 2010 analysis that estimated the 2010 federal health law’s effects on Medicare spending and was put together by the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT). It covered the budget years 2010-2019. 

Read the complete article here.

There’s an app for that – In China, track food scandals with a iPhone app

From the International Herald Tribune/New York Times:

There’s mercury in the baby formula. Cabbages are sprayed with formaldehyde. Gelatin capsules for pills, tens of millions of them, are laced with chromium. Used cooking oil is scooped out of gutters for recycling, right along with the sewage.

Accounts of dubious or unsafe food in China are as mesmerizing as they are disturbing — “artificial green peas,” grilled kebabs made from cat meat, contaminated chives, chlorine showing up in soft drinks.

There have been stories of imitation soy sauce made from hair clippings, ink and paraffin being used to dress up cheap noodles, and pork buns so loaded with bacteria that they glow in the dark.

A new investigation by the Chinese magazine Caixin has found that “these publicized food safety scandals represent only a fraction of unsafe food production practices. Hundreds of chemical food additives are pumped into products that Chinese people consume every day.”

The official Chinese news agency Xinhua reported Wednesday that Chinese authorities have discovered 15,000 cases of substandard food so far this year while shutting down 5,700 unlicensed food businesses.

Things are so bad that a new iPhone app was recently launched to track food scandals nationwide. The app, which sends out daily updates on the latest outrages, was reportedly downloaded more than 200,000 times in the first week.

Read the complete story here.

The promise of social impact bonds

From the New York Times:

When a government needs to invest in an expensive capital project — a new sewer system, bridge or highway — it issues bonds. Bonds raise upfront money from private sector investors, who are then paid back with interest from the tolls or charges the project will generate.

Until now, no one ever issued a bond to invest in people like Popeye.

Popeye is a short, bearded man of 59 who often wears an earring and a cap.His real name is Robert Innes, but he acquired the nickname 25 years ago in prison. He started drinking at 13, and three years later began living on the streets, which continued until November of last year. When he was on benders, Popeye would steal beer and panhandle aggressively. His untreated heart problems would land him in the emergency room unconscious, and when he woke up would start a fight. He also gave new meaning to the term “repeat offender.” He said he has been incarcerated in his home town of Norwich, England, 118 times, and in Peterborough, where he lives now, 48 times.

Popeye used the prison system for housing, the emergency room for basic medical care and the courts as his support system.

This lifestyle is more than a tragedy for Popeye; it’s a tragedy for taxpayers. Just to keep Popeye alive —never mind helping him to change — was hugely expensive. . . .

A brand-new financial instrument may provide a way out of this dilemma. In September, 2010, in Peterborough, a town about an hour’s train ride from London, the first test began of a new idea that in a very short time has caught the attention of governments around the world.  They see it as a way to provide third-party upfront money for prevention programs they might not otherwise be able to afford.   The idea is called the social impact bond.

It has transformed Popeye’s life. At Christmas, Popeye got the keys to an apartment, and he has proven to be a meticulous housekeeper. He had help learning how to live in an apartment — how to connect utilities and manage his bills. His caseworkers helped him to get an ID card and bank account, and register with a doctor so he could use Britain’s National Health Service. They went with him to appointments and took him shopping (he had been banned from most local stores for his antisocial behavior). He got psychological counseling. He was encouraged to become a volunteer. He is starting cooking classes.

To read the complete article, click here.

“They Paved Paradise And Put Up A Parking Lot”

From Health Affairs, a “Narrative Matters” essay as a doctor’sthoughts turn to public health when a patient loses a park to exercise in and his health deteriorates.

The patient sat in the squeaky chair in my exam room and told me his back hurt. He was a Hispanic man in his early forties; I’ll call him by his first initial, P. It was 2007 and I was a new doctor, just out of medical school, starting my medical residency in a primary care clinic.

I went through the usual barrage of questions designed to rule out the most lethal causes of back pain: Did it wake him up at night? Was it worse when he was lying down? Had he recently lost weight?

No, he hadn’t lost weight, he said. Just the opposite. He’d gained forty pounds in the past six months.

I probed deeper. Was he eating more for some reason? Was he depressed? Were there problems with his marriage? Had he recently lost his job?

Nothing like that, he said.

The problem was the Yankees.

To read the complete article, click here.

Lecture – The Fukushima Disaster: Law, Politics, and Compensation in Japan

Eric Feldman, Professor of Law at the University of Pennsylvania, will speak today on the compensation committee set up by the Japanese government in the wake of the devastating earthquake, tsunami, and nuclear power plant destruction last year.

The March 11, 2011 Fukushima disaster in Japan left hundreds of thousands of people homeless, jobless, and in deep despair. In an effort to help them cope with their losses, the government appointed a high-level committee to develop compensation guidelines. But those guidelines were meant only for the harms that resulted from the meltdown at Tepco’s Fukushima Dai-ichi Nuclear Power Plant. Simultaneously, a government dispute resolution process was created for individuals and companies seeking compensation for nuclear-related damages. These compensation efforts raise a number of difficult questions. Which victims of the Fukushima disaster deserve compensation, and for what types of harms? Why did the government and Tepco agree to provide compensation to the victims of the nuclear accident, but not to the victims of the earthquake or tsunami? To what extent does the Fukushima compensation scheme resemble similar schemes in the US, like those created after 9/11 and the recent Deepwater Horizon gulf oil spill? What should we learn from the situation in Fukushima about disasters, compensation, and justice in Japan, and beyond? 

  • Date:  12 April
  • Time:  12:10-1:00
  • Location:  1636 School of Social Work Bldg

Sponsored by the Center for Japanese Studies.

Lecture – Greenhouse Gas Emissions: Where Law and Politics Intersect

 Trip Van Noppen, president of Earthjustice, will present a talk on 10 April, “Greenhouse Gas Emisons:  Where Law and Politics Intersect.”  This free lecture is part of the Law School’s Environmental Law and Policy Program Lecture Series.

  • Date:  10 April
  • Time:  4-5:00
  • Location:  250 Hutchins Hall

For a complete list of past speakers as well as videos of their presentations (when available), visit the ELPP Lecture Series Archive Page.

In Haiti, Global Failures on a Cholera Epidemic

From the New York Times, an important story on the handling of the cholera epidemic in Haiti.

[C]holera has killed more than 7,050 Haitians and sickened more than 531,000, or 5 percent of the population. Lightning fast and virulent, it spread from here through every Haitian state, erupting into the world’s largest cholera epidemic despite a huge international mobilization still dealing with the effects of the Jan. 12, 2010, earthquake.

The world rallied to confront cholera, too, but the mission was muddled by the United Nations’ apparent role in igniting the epidemic and its unwillingness to acknowledge it. Epidemiologic and microbiologic evidence strongly suggests that United Nations peacekeeping troops from Nepal imported cholera to Haiti, contaminated the river tributary next to their base through a faulty sanitation system and caused a second disaster.

“It was like throwing a lighted match into a gasoline-filled room,” said Dr. Paul S. Keim, a microbial geneticist whose laboratory determined that the Haitian and Nepalese cholera strains were virtually identical.

And, as the deaths and continuing caseload indicate, the world’s response to this preventable, treatable scourge has proved inadequate. Cholera, never before recorded in Haiti, stayed one step ahead of the authorities as they shifted gears from the earthquake recovery. While eventually effective in reducing the fatality rate, the response was slow to get fully under way, conservative and insufficiently sustained.

Read the complete story here.


Behind the healthcare-law case – The challengers’ tale

From the New York Times and Reuters:

A little over a year ago, Florida Attorney General Pam Bondi was on a mission. Along with a group of like-minded officials from other states, she was determined to be the first to test President Barack Obama’s healthcare reform law at the U.S. Supreme Court. And she wanted to find the right lawyer to do it. . . .

Bondi had borrowed a conference room at a Washington law office where her brother was a partner, and her team heard pitches from three law firms winnowed down from a lengthy list.

In the end, Paul Clement, a partner at the law firm King and Spalding LLP who had been a U.S. solicitor general under President George W. Bush, prevailed with arguments Bondi and her associates later described as “passionate,” a manner they called “humble,” and an eventual price tag that was especially attractive.

The choice of Clement on that cold day 13 months ago was one of several critical moments that defined the arc of the dispute the justices will hear over an extraordinary three days of arguments on March 26-28.

Read the complete story here or here.