Behind the Unproven H1N1 Flu Vaccine

Posted on: August 27, 2009  |   Author: Gina
Filed Under: Drug & Device, Life Sciences, Other, Public Health Policy   |   Leave a Comment

Have public officials sparked global fears about the H1N1 - commonly referred to as swine flu? This week, a new estimate that 90,000 Americans could die of H1NI was released as discussions about preparing this season’s flu vaccine - a positive epidemiological planning step that should be reassuring, not alarming.

At this point, the CDC has approved the still-experimental vaccine to be bottled and shipped - despite results from the trials. This recommendation was handed down by the President’s Council of Advisers on Science and Technology (PCAST). However, this does not mean that anyone will get an unproven vaccine - the vials will remain stored until the results from the trials are verified - but this step is to assure that if the results are positive, the US will be prepared to fight this growing pandemic. The first of these trials occurred in August - with hope that it will be confirmed by October.

In its report, PCAST also released projections of how severe the pandemic could get: up to 120 million people coughing, sneezing, feverish and otherwise sick with the symptoms of flu, 90,000 people potentially dead from the illness, and half to 100% of beds in intensive care units of hospitals in hard-hit regions filled with flu patients. These figures are derived from previous flu pandemics from 1918, 1957 and 1968 combined with data from last spring’s H1N1 outbreak worldwide.

Currently, it’s challenging to consider valid statistics as it is difficult to determine the extent of infection, how the disease is spreading, the additional ramifications - and especially the death rates since the previous statistics may be unreliable. Officials can only count the number of people who have seen a doctor, come to a hospital and have a confirmed case - and make projections about who is infected but not seeking health care services.

By no measure, however, were the new numbers reassuring-and that was the point. The statistics are intended to indicate just how devastating this pandemic could be should the United States not take appropriate measure to confine the pandemic. These projections assist government officials and vaccine manufacturers in estimating just how much of the vaccine they need to produce - as well as assuring that antiviral drugs such as Tamiflu and Relenza are stockpiled and readily available for the sickest populations.

For the moment - consider the statistics thoughtfully and know that experts are planning for this pandemic.
TIME, August 26, 2009.

Should NCAA Require Universities to Provide Athletes Health Insurance?

Posted on: August 25, 2009  |   Author: Patrick
Filed Under: Healthcare Reform, Public Health Policy   |   Leave a Comment

After years of concern about inadequate health insurance coverage for college athletes, the National Collegiate Athletic Association (NCAA) issued a new rule that required athletes to have health insurance before competing. However, the rule, instituted four years ago, never provided a clear standard and left schools without any oversight. While some colleges provide their student athletes with excellent coverage, many schools refuse to accept any financial responsibility for medical claims, leaving students and their families with significant unexpected medical bills.

Erin Knauer, a Colgate University student athlete, suffered a strained back and bulged disk during a crew team practice. After two trips to the emergency room, a week in the hospital, and extensive physical therapy, the 20-year-old freshman faced an $80,000 medical bill. Knauer was diagnosed with postviral myositis, a form of muscular inflammation. University officials determined her condition to be an illness rather than a sports related injury and declined to take financial responsibility for Knauer’s medical bills.

Had Knauer been covered under the university health plan, her treatment expenses would have been paid for by Colgate’s athletic insurance after a $1,000 deductable. Instead, she was forced to exhaust her student health policy worth $25,000 and work two jobs to pay for the $55,000 she still owed. After paying off some debt, she still owes almost $8,000 and is constantly faced with bill collectors threatening to sue her.

Jason Whitehead, a former football player at Ohio University, was airlifted to a hospital after he sustained a serious injury during practice that left him temporarily paralyzed. When he took his unpaid medical bills to his father’s insurance company and to the Ohio University trainers, they both refused to pay the claims. Six years later, while trying to purchase a car, Whitehead discovered he still owed $1,800 in unpaid medical bills.

Some believe that a school should provide student athletes with health coverage while they compete for the institution. Charlie Just, the compliance director at Spalding University, says, “Ethically, it’s the right thing to do.” Others believe that providing student athletes with insurance is just part of the cost of having an athletic program. As David Dranove, a professor of health industry management at Northwestern University argues, refusing to pay for athletes’ health insurance makes just as much sense as telling them to pay for their own equipment and traveling expenses.

Many large universities with nationally recognized athletic programs and lucrative television contracts have the financial resources to afford comprehensive coverage for all their varsity athletes. For example, the University of Iowa paid 4,200 medical bills last year totaling $776,454 and started to pay for uninsured full-scholarship athletes to enroll in the school’s student health care program.

Sadly, many athletes attend schools that do not provide the same coverage and are hit with massive medical bills after being injured. Their stories and the absence of mandated coverage for athletes has prompted calls for change. Advocacy groups such as the National College Players Association are lobbying for legislation to further protect NCAA athletes. Last summer, a number of college players brought a class-action suit against the NCAA and argued that their scholarships did not adequately cover certain living expenses, including medical bills. As part of a settlement agreement, the NCAA was required to create a $218 million relief fund for college athletes.

Given the current financial climate, it could be too financially demanding to require all universities to provide coverage for athletes. However, with health reform looming in the near future, increasing coverage for NCAA athletes could soon become a reality.

Commentary: Student athletes who compete in sports at the college level go through grueling workouts, rigorous training, and push themselves to the limit almost every day. They sacrifice their bodies and march into battle game after game as they proudly represent their institution. However, injuries are an unfortunate reality in any sports and can lead to expensive treatment and rehabilitation. College students lack the financial resources to pay for expensive medical bills and should not bear the risk of injury without insurance. At the very least, schools should inform student athletes of the risk associated with lack of coverage and provide them with a university health plan option. While insuring all athletes under the current system may be too cost-prohibitive, health reform could provide an answer to expanding coverage for college athletes.

The New York Times, July 15, 2009.

Does an Individual Mandate Violate the Constitution?

Posted on: August 17, 2009  |   Author: Stephen
Filed Under: Other   |   Leave a Comment

After it became apparent that an individual mandate for purchase of health insurance was included in both the Senate and House health reform bills, the debate began over the constitutionality of such a mandate.  The argument takes place on two fronts, the Commerce Clause and the Takings Clause

Conversation primarily centers around the Commerce Clause, with supporters of the mandate arguing that since the New Deal, the federal government has retained the power to regulate interstate commerce.  “Although health delivery is often local, most medical supplies, drugs and equipment are shipped in interstate commerce. More to the point, most health insurance is sold through interstate companies.”  Opponents of the mandate argue that this does not apply to citizens who refuse to participate in the interstate commerce, but are met with counterpoint that the action of refusal actually has an effect on interstate commerce, because in shrinking the risk pool of insured the premiums would incrementally rise.

As for the Takings Clause, opponents of the mandate believe that forcing a citizen to pay for a service they do not want and will not use violates the prohibition of government taking of property without just compensation.  Supports of the mandate return that the classic “taking” applies to an individual, while  the mandate would apply to everyone, and so this could be seen more like a tax than a taking.  Further, the individual does receive medical insurance which is worth a comparable amount.

Commentary: This was an interesting, accurate, and fair analysis of a notable side issue in the health reform debate. It’s important to keep in mind, particularly in light of so much mis-information being crammed into the popular consciousness, that there are important legal issues which go along with health reform.  As part of a profession which is trained to make informed, compelling arguments that must be supported by a factual premise, we are in a unique position to debate these issues without the vitriol and distrust that permeates the national debate.  This article is an excellent example of such conversation.

From “Can Barack Obama Make you Buy Health Insurance?” (Slate.com), August 4, 2009.

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