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More evidence essential oils ‘make male breasts develop’

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A suspected link between abnormal breast growth in young boys and the use of lavender and tea tree oils has been given new weight, after a study found eight chemicals contained in the oils interfere with hormones.

Gynaecomastia is rare, and there is often no obvious cause.

But there have been a number of cases linked to use of these essential oils.

The American study found that key chemicals in the oils boost oestrogen and inhibit testosterone.

Not everyone will have the same reaction to an essential oil.

The plant-derived oils are found in a number of products such as soaps, lotions, shampoos and hair-styling products. They’re also popular as alternative cleaning products and medical treatments.

Lead researcher J. Tyler Ramsey from the National Institute of Environmental Health Sciences (NIEHS), in North Carolina, suggested caution when using the oils.

“Our society deems essential oils as safe. However, they possess a diverse amount of chemicals and should be used with caution because some of these chemicals are potential endocrine disruptors.”

A growing number of reported cases of male gynaecomastia have coincided with topical exposure to the oils.

After they stopped using the products, the symptoms subsided.

A previous study by Dr Kenneth Korach – who was also co-investigator for this study – found that lavender and tea tree oil had properties that competed with or hindered the hormones that control male characteristics, which could affect puberty and growth.

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The new study looked at eight key chemicals from the hundreds that make up the oils. Four of the tested chemicals appear in both oils and the others were in either oil.

They were tested on human cancer cells in the laboratory to measure the changes.

The researchers found all eight demonstrated varying degrees of promoting oestrogen and/or inhibiting testosterone properties.

“Lavender oil and tea tree oil pose potential environmental health concerns and should be investigated further,” said Mr Ramsey.

Many of the chemicals tested appear in at least 65 other essential oils, which is of concern, he added.

Essential oil guidelines

  • Precautions should be observed when using essential oils since they are highly concentrated
  • Do not apply undiluted essential oils directly to the skin
  • Never use undiluted oils on children under the age of three
  • If you are pregnant you should seek the advice of your doctor, midwife before using essential oils
  • When used appropriately, essential oils and aromatherapy products are safe for all the entire family
  • Source: Aromatherapy Trade Council

Prof Ieuan Hughes, emeritus professor of paediatrics at the University of Cambridge said the findings “have confirmed why an individual using such oils containing these chemicals may develop breast tissue”.

“The anti-male hormone effects are rather unexpected and it is not possible to comment further without the data.

“Of course, not everyone exposing themselves to such oils has adverse effects, so it is possible there are particular individuals who may be more sensitive to the effects of the chemicals, or perhaps are using the products in excess.

He said attention should be given to better regulation of these products.

Prof Hughes added: “Clearly, the longer-term effects of such exposure are unknown.”

Dr Rod Mitchell, honorary consultant paediatric endocrinologist at the Queens Medical Research Institute in Edinburgh said the study “is important in establishing a possible mechanism for the suggested link between gynaecomastia and exposure to lavender and tea tree oils”.

“However, there are important factors that must be taken into account when interpreting these results. The tests are conducted in cancer cells, which may not represent the situation in normal breast tissue.

“The concentration (dose) to which the cells are exposed may not be equivalent to exposure in humans. There is a complex relationship between oestrogen, testosterone and other hormones in the body, that cannot be replicated in these experiments.”

He called for further larger studies.

“At present, there is insufficient evidence to support the concept that exposure to lavender and tea tree oil containing products cause gynaecomastia in children, and further epidemiological and experimental studies are required.”

The study results will be presented on 19 March at the Endocrine Society’s annual meeting in Chicago.

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Death penalty for drug traffickers part of Trump opioid plan

President Donald Trump’s plan to combat opioid drug addiction nationwide calls for stiffer penalties for drug traffickers, including the death penalty where appropriate under current law, a top administration official said Sunday. It’s a fate for drug dealers that Trump, who aims to be seen as tough on crime, has been highlighting publicly in recent weeks.

Trump also wants Congress to pass legislation reducing the amount of drugs needed to trigger mandatory minimum sentences for traffickers who knowingly distribute certain illicit opioids, said Andrew Bremberg, Trump’s domestic policy director, who briefed reporters Sunday on the plan Trump is scheduled to unveil Monday in New Hampshire, a state hard-hit by the crisis.

The president will be joined by first lady Melania Trump, who has shown an interest in the issue, particularly as it pertains to her focus on child welfare.

Death for drug traffickers and mandatory minimum penalties for distributing certain opioids are just two elements under the part of Trump’s plan that deals with law enforcement and interdiction to break the international and domestic flow of drugs into and across the U.S.

Other parts of the plan include broadening education and awareness, and expanding access to proven treatment and recovery efforts.

Trump has mused openly in recent weeks about subjecting drug dealers to the “ultimate penalty.”

The president told the audience at a Pennsylvania campaign rally this month that countries like Singapore have fewer issues with drug addiction because they harshly punish their dealers. He argued that a person in the U.S. can get the death penalty or life in prison for shooting one person, but that a drug dealer who potentially kills thousands can spend little or no time in jail.

“The only way to solve the drug problem is through toughness,” Trump said in Moon Township.

He made similar comments at a recent White House summit on opioids. “Some countries have a very, very tough penalty — the ultimate penalty. And, by the way, they have much less of a drug problem than we do,” Trump said. “So we’re going to have to be very strong on penalties.”

The Justice Department said the federal death penalty is available for several limited drug-related offenses, including violations of the “drug kingpin” provisions of federal law.

Doug Berman, a law professor at Ohio State University, said it was not clear that death sentences for drug dealers, even for those whose product causes multiple deaths, would be constitutional. Berman said the issue would be litigated extensively and would have to be definitively decided by the U.S. Supreme Court.

Opioids, including prescription opioids, heroin and synthetic drugs such as fentanyl, killed more than 42,000 people in the U.S. in 2016, more than any year on record, according to the Centers for Disease Control and Prevention. Trump has declared that fighting the epidemic is a priority for the administration but critics say the effort has fallen short.

Last October, Trump declared the crisis a national public health emergency, short of the national state of emergency sought by a presidential commission he put together to study the issue.

“We call it the crisis next door because everyone knows someone,” said Kellyanne Conway, a Trump senior adviser. “This is no longer somebody else’s community, somebody else’s kid, somebody else’s co-worker.”

Other elements of the plan Trump will discuss Monday call for a nationwide public awareness campaign, which Trump announced last October, and increased research and development through public-private partnerships between the federal National Institutes of Health and pharmaceutical companies.

Bremberg said the administration also has a plan to cut the number of filled opioid prescriptions by one-third within three years.

The stop in New Hampshire will be Trump’s first visit as president. He won the state’s 2016 Republican presidential primary but narrowly lost in the general election to Hillary Clinton. It follows a visit to the state last week by retiring Sen. Jeff Flake, R-Ariz., a persistent Trump critic. Flake told New Hampshire Republicans that someone needs to stop Trump — and it could be him if no one else steps up.


Associated Press writer Mark Sherman contributed to this report.


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How Health and Education Journalists Can Turn Privacy Laws to Their Advantage

This story was co-published with the Association of Health Care Journalists.

For decades, the Judge Rotenberg Center, a school for children with developmental and behavior disorders in Canton, Mass., employed brutal methods to discipline students, including electric shock therapy. My colleague, Heather Vogell, and I anticipated that government data on student complaints would shed light on the school’s practices, but realized that student privacy laws protected those records from disclosure. By requesting the records with certain personally identifiable information removed, we were able to abide by the law and still document incidents of harsh punishment at the school.

Most journalists who cover health or education struggle to obtain government records and data that are vital to our stories and have compelling public interest. While some agencies are reasonably accommodating, others exploit every loophole or gray area in the law to deny public records requests—or delay in the hope that the journalist will move on to another story and stop bothering them. Health and education records are especially elusive because of federal laws that protect the privacy of patients and students.

ProPublica has often negotiated with or contested rulings by government institutions to pry data out of them. Our persistence has led to groundbreaking findings, such as our analysis of birth complications for our “Lost Mothers” series. Over the years, I have amassed a variety of tips and tricks on how to overcome or circumvent these restrictions. I shared the following strategies last week with more than 1,200 reporters at the National Institute for Computer-Assisted Reporting (NICAR) conference.

Know the Laws

The federal Freedom of Information Act (FOIA) allows records officers to deny your request under nine restrictions, or exemptions. They protect records related to national security, internal agency rules, trade secrets, internal agency memos, personal privacy (also known as (b)(6) or exemption 6), law enforcement, banks, oil and gas wells, and any records that are exempt under other laws. States also have open records laws, and their exemptions frequently echo federal restrictions.

Two key federal laws protect the private information of patients and students: the Health Insurance Portability and Accountability Act (HIPAA), and the Family Educational Rights and Privacy Act (FERPA). Along with exemption 6, these laws are commonly cited in denials of health and education data requests.

HIPAA, a 1996 law, aims to make it easier for health care organizations and companies to use electronic records so that medical data can quickly be transferred. It applies to health care offices and institutions (for example: doctors, clinics, nursing homes, pharmacies, universities, insurance companies and more), as well as any organization that electronically transmits health care data, including schools, prisons, and detention facilities.

HIPAA’s privacy protections last 50 years after a patient dies. After death, an executor or surviving family member may decide whether to disclose personal health information.

Enacted in 1974, FERPA protects the privacy of student’s “education records” and limits disclosure. Federal funds may be withheld if schools violate FERPA. Because nearly all public K-12 schools, colleges and universities receive public funds, nearly every educational institution in the country is covered by FERPA. The protected data includes information such as student or parent names, addresses, Social Security numbers, fingerprints, place and date of birth, as well as educational records.

Be Prepared Before Filing a Data Request

  • First, find out if the data exists. Look online or phone the government entity and ask for data schemas, dictionaries and repositories (specifically discussing with a records officer which “limited use” data sets may be available). If you plan to file a request with a particular state, familiarize yourself with the state’s data reporting requirements. Ask a public affairs officer for the data before filing a formal request. Explain to the records officers that you don’t want to waste their time or yours.
  • Track down the internal data wizard. Try to speak with data custodians, or the people responsible for maintaining the databases, instead of, or in addition to, a public affairs or records officer. They know the data best and can help you tailor your request.
  • Always request an itemized cost estimate. Government agencies sometimes calculate exorbitant cost estimates for fulfilling your request. Make sure you seek an itemized estimate to see if they are over-charging you.
  • Negotiations are crucial. Explain to the records officer that you are willing to negotiate the scope of your request to avoid privacy restrictions by redacting or removing certain fields.
  • If you plan to request data from a state government, familiarize yourself with its open records memoranda and legal decisions. State attorneys general frequently rule on thorny records requests. If your request seems legally dicey, look up recent attorney general decisions related to privacy restrictions.

Even with HIPAA, You Can Still Get ‘De-Identified’ Data

If a data set has been “de-identified,” HIPAA’s privacy rules do not apply. There are two methods for de-identification: “safe harbor,” which suppresses fields that reveal personally identifiable information, and “expert determination,” which relies on experts to verify that there is a limited risk of identifying patients.

  • Check if de-identified data is available for download online. Local and state health agencies sometimes put de-identified data sets online. These data sets have minimal, if any, restrictions on their use.
  • Ask a records officer to remove personally identifiable fields. If the health data you want includes any personal identifiers, consider requesting the data with these variables removed or redacted. If there are account or Social Security numbers to identify each patient, ask for dummy IDs (but make sure to find out which variables have been replaced by dummy numbers).
  • Request aggregate data. Some records officers may deny your request on the grounds that aggregating data is the same as “creating” data, which they may not be legally obligated to do. So ask nicely, and negotiate! If you are able to get aggregated data (or data you can only publish in an aggregate form), you may be prohibited from publishing data on small groups of people in order to protect the privacy of patients.

If the Government Won’t Help, Try These Sources

  • Depending on the hospital, you may be able to request information from the “hospital directory,” which has basic facts about current and recent patients, including patient names and conditions, and where they are being treated within the hospital.
  • Hospitals, state agencies and the federal government can release statistical data on hospital billing.
  • Medical examiners are not covered by HIPAA, although they may be covered by state privacy laws.
  • In some states, you may be able to get information from public ambulance or emergency medical services.
  • People are entitled to their own records, and can share them with journalists if they so choose.
  • At ProPublica, we’ve had success obtaining patient-level data through an institutional review board (IRB) process. We found a non-university-affiliated board that was willing to review and approve our protocol, satisfying a government agency that had initially rejected a FOIA request. You can read more about our IRB process here.

When De-Identified Data Isn’t Enough, Try a Restricted-Use Data Set

Organizations covered by HIPAA are allowed to create data sets containing protected health information that may be disclosed for research purposes, with the understanding that the researcher signs a data use agreement. Some agencies give journalists access to limited- or restricted-use data sets, as long as they abide by the same rules as researchers.

  • Make sure the data exists. Call the institution and ask what data sets are available in the limited and restricted form.
  • Inquire if the data would be available if you sign a data use agreement. Ask about what process researchers generally undergo to obtain data and whether it’s available to journalists as well.
  • Review data use agreements with an attorney or your newsroom’s counsel. Make sure you understand the fine print.
  • Understand the publishing restrictions. Many agreements limit how the data can be published (for example, an agreement might not allow you to publish raw data). Make sure you are aware of the restrictions before you sign a document, and negotiate the terms if you need to.
  • Keep track of termination dates. Some agreements only last a few years. Make sure you update the contract when necessary.

What to Include in the Data Use Agreement:

  • Statement of intent: This statement should include information about your news organization, what you plan to study, and the goals of your research.
  • Description of the data: The agreement should identify the specific data files that the organization is providing, including the time periods of the data sets. Always double check that you’re being given the time frame you want.
  • Payment: You should negotiate the fee for the data before seeing the data use agreement. Prices may be pre-set and listed on a health agency’s website.
  • Data uses: Most data use agreements explain clearly how the data can be used and what text should be included in your story related to source of data.
  • List of all reporters: With every agreement, include a list of all reporters who are or may be interested in working with the data.

Even with FERPA, You Can Obtain Student Data

Depending on the school or school system, you may still receive “directory information,” which describes aspects of a student’s educational record that would not “be considered harmful or an invasion of privacy if disclosed.” It typically includes: name, address, phone numbers, emails, photo, participation in activities or sports, dates of attendance, major field of study, grade level, enrollment status, weight and height of athletes, degrees, honors or awards and most recent educational institution attended. Under the law, parents may request to remove their child’s information from a directory.

Aside From Directory Information, FERPA Allows You to Request:

  • Instructional data: Data related to teaching and administrative roles is not considered “education records,” and is not covered by FERPA.
  • Law enforcement or campus security data: School police units are generally not covered by FERPA. If their records are created for a non-law-enforcement purpose (for example, student suspensions), the data may be subject to FERPA restrictions. Additionally, states have varying privacy laws related to juvenile crime.
  • Health or emergency records: Institutions may release records without a student’s or parent’s permission if necessary to safeguard student health or safety.
  • School employment data: Data related to staff members at the school is not covered by FERPA, unless the employee is also a student.
  • Scholarship and award data: Because it can be considered directory data, this information may not be subject to FERPA restrictions. Still, colleges and universities have tried to use FERPA to deny requests for this information, prompting some reporters to file lawsuits seeking its release, with mixed success.
  • Spending or contracting data: As this data does not relate to “education records,” it is, for the most part, not covered by FERPA.

To sidestep FERPA restrictions, you may be able to request aggregated data or for the personally identifiable fields to be redacted or removed. Sometimes, as with HIPAA, an entity will require a journalist to sign a data use agreement. Many of the same tips related to HIPAA apply.

Have any additional questions? Feel free to email Annie at

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These Entrepreneurs are Addressing the Growing Need for Mental Health Counseling Platforms

You’re reading Entrepreneur India, an international franchise of Entrepreneur Media.

Before diving down to that, let’s touch upon on what’s driving the growing chorus for such counseling platforms. Apart from the obvious figures quoted by World Health Organisation last year – around 94 million Indians suffers from some or the other mental issues such as depression of various types and anxiety disorders – there is a lack of accessible treatment. That’s because first, hospitals are not interested in investing time and resources in the space as there is no in-patient revenue for them.

“A hospital thrives on the revenue from operation theatre but for mental health treatment there is hardly any surgery involved,” says Davesh Manocha who launched Juno Clinic – online clinic for mental wellness along with Arun Kumar and Anuraag Srivastava. Second, almost 80 per cent of India’s top psychologists and psychiatrists are scattered across top five-six cities. This means no basic access to mental health therapists beyond these cities and hence, online treatment is the only alternative. Third, as families are getting nuclear, talking to the family members is getting improbable today. “Mental health issues could be taken care of by talking to someone in a joint family set up but now there is only so much that can be done,” says Dr Amit Malik, Founder and Chief Executive Officer, InnerHour and a trained psychiatrist since over a decade.

Value Game

So the demand for psychological wellness is taking shape. But is there value creation in such platforms and if yes, how that could be apparent to patients? That’s the first big problem since historically it has been significantly affiliated to social disgrace and conventionally the patient has been stamped as psychopath with abnormal or violent social behavior. Consequently, there has also been an issue of privacy as the patient or his/her family members or friends don’t want the problem to be disclosed to their social circle. But that attitude is fast changing with increased social acceptance.

“As the stigma attached is disappearing, mental health is now getting productized. So there are programs for depression, de-addiction, stress, anxiety etc.,” says Dr Vijay Raaghavan, Associate Director, Healthcare, PricewaterhouseCoopers India. Hence, instead of going to a therapist or a counselor offline, where there is a standard process to de-stress, separate programs allow patients and counselors for problem-specific sessions. Moreover, since the sessions are online-first, which includes chat and phone-based (audio and video) support, it solves the problem for lack of privacy.

For instance, counseling for de-addiction of drugs wherein the patient fears of being labeled as an addict socially, the online channel with better privacy control mitigates that issue. “This further reduces the overall cost for the program, even as it helps counselors deliver better value to the patient,” adds Raaghavan. It usually costs upwards of INR 1,000 for a session of 50-75 minutes offline versus INR 400 and above on the online platforms. For example, YourDost, another similar platform charges INR 1,000 per week for five-week program on marital relationship, whereas a regular relationship counselor charges over INR 1,500 per session. But much like in any healthcare business, the most important factor for success for these start-ups too is the clinical efficacy.

Since the delivery of treatment is taking place digitally, hence the workflow right from recording patient details, diagnosing the problem, counseling, and medication if required has to be seamless. This means that element of collaboration has to be deeply engrained in the process since there are multiple people involved in a single case – counselor or therapist, psychiatrist prescribing medication, psychologist doing the assessment etc. “Telemedicine in healthcare is just a delivery layer to connect the doctor and the patient but the business has to be built around telemedicine,” adds Manocha. For example, at Juno Clinic, the patients can begin with choosing the therapist and the time slot, pay for the session and start with the counseling. At the backend, the patient details are synced with the psychiatrist and psychologist for medication and further

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Wired Health 2018: Old tech, new ideas

This week, we attended the Wired Health conference in London. As always, the event was jam-packed with innovators jostling for position in the race toward a brighter, healthier future.

This year’s Wired Health conference was as informative and insightful as ever.

Wired Health is held yearly in London, United Kingdom. It boasts a wide array of speakers from every corner of the health tech world, alongside forward-thinking companies who provide a glimpse of their latest offerings.

This year was as varied as ever, and the talks covered how technology could intervene in issues as diverse as HIV, bereavement in children, and cardiovascular surgery.

I spent the majority of my time at the EY WIRED Health Access Stage, which featured an annual showcase of start-up companies.

For me, the over-arching theme this year was one of consolidation. I saw less focus on newfangled technology and more emphasis on the use of recent innovations in more efficient ways.

Rather than designing solutions from the bottom up, it seems to be more about capitalizing on hard-won inventions of the recent past.

We have the data — now what?

Early on in the proceedings, Pamela Spence — the Global Life Science Leader at EY — reminded us that we are currently knee-deep in the fourth industrial revolution. And, key to this brave new dawn is that four letter word that promises so much: data.

Big data is here. What’s the next step?

Today, capturing data is easier than ever. There are more data available to us than we could have dreamt of just a decade ago. We have almost unlimited processing power at our fingertips.

The question is, which bits do we pay attention to, who gets to share it, and what shall we do with it?

Spence spoke of the problems with collating this new-found swarm of numbers. Healthcare data tend to be spread out and distributed into different silos.

If they could be combined more efficiently and analyzed effectively, they could be harnessed for the greater good.

She quipped that clinicians used to be supported by data scientists but, more and more, data scientists are being supported by clinicians.

This is the future of health tech. However, at the moment, you get the feeling that the data we are harnessing are nowhere near as useful as they promise to become.

One company bent on harnessing medicine’s new-found ocean of data is Heterogeneous. Though gene sequencing has been available for some time, Heterogeneous are offering whole-genome sequencing at rates cheaper than could have been imagined just a handful of years ago.

Anyone can sign up, and, once you have had your genome sequenced, you get full ownership of your data. You are then able to select which research projects you would like to make your data available to.

Heterogeneous pass your genome (anonymously) over for their study. The researchers receive good-quality data quickly, and you receive the warm satisfaction of advancing science passively from your armchair.

This is not a new idea; plenty of companies offer genomic information to consumers. However, most other companies sell these data to third parties without informing the customer. This is completely legal and above board, but Heterogeneous want to be part of a more open and collaborative future.

Big data vs. personalization

Although many of the changes in healthcare are predicted to come from the rich tapestry of data that we collect, there are also changes at the other end of the spectrum: personalized medicine.

Bruce Levine — from the University of Pennsylvania in Philadelphia — spoke to an enthralled audience about his work with chimeric antigen receptors (CAR)-T cell therapy.

In this technology, cancer patients’ immune cells, or T cells, are removed, then genetically trained to target cancer cells and reintroduced into the patient.

Already tested in leukemia and lymphoma, CAR-T can save lives — a single infusion with the newly trained T cells can wipe out “kilograms” of tumor cells. Though the method cannot yet attack solid tumors, Levine and his colleagues are hot on their heels.

This intervention is very much tailored to the individual. In fact, he likened it to an organ transplant rather than a pharmacological intervention, calling it the “ultimate in personalized treatment.” The patients’ own cells are groomed to recognize and destroy the specific cancer that they carry.

Levine’s story also provides a little insight into how quickly a medical technique can move from the outskirts to the mainstream.

He recalled that, just a few years back, he and the other researchers investigating the potential of CAR-T were regarded as the “quaint” guys in the corner. Now, they’re the “hot thing,” Food and Drug Administration-approved, and, rightfully, the center of attention.

Generation App

Tech conferences the world over are awash with smartphones and apps. I had to stop myself from rolling my eyes when I saw the number of app-based solutions at Wired Health this year. But I shouldn’t roll my eyes.

Yes, I was disappointed that there weren’t more laser-wielding robots and X-ray-powered rocket shoes, but this was a science conference, not a science fiction conference (Medical News Today won’t pay for my Comic-Con ticket).

Apps are accessible to millions of people worldwide via a few taps on a device kept in their pocket. Their incredibly swift rise to ubiquity — let’s try to remember that Apple’s App Store only opened its digital doors in July 2008 — makes them a potentially powerful tool for the good of humanity’s health, if wielded in the right hands.

One such pair of safe hands belongs to Clinova, who have developed an app called Caidr.

Any health-focused conference in the U.K. is almost duty-bound to mention the struggling British National Health Service. Although the reasons for its troubles are largely political, finding ways to cut corners and save cash are of particular interest.

Caidr, which was designed by two pharmacists, helps users to “distinguish minor ailments from a more serious illness.” By answering a series of simple questions, the app’s algorithms assess whether they need to visit a doctor or if a pharmacist could offer effective over-the-counter medications.

Some examples of Caidr screenshots.

In the United States, where waiting times to see a doctor have sky-rocketed over recent years, this app could help to take the pressure off.

Another company who are offering an easier, mobile-based route to healthcare is Index Ventures, who have created an app called Kry. The app allows you to speak with a doctor directly via your cell phone.

This saves both the doctor’s and patient’s time and is significantly easier than having to take time off work or juggle other commitments to visit the doctor’s office. It is particularly useful for people who cannot visit the doctor easily or who live in isolated regions.

Kry is already part of Sweden’s health service, and 2 percent of all primary care appointments take place through the app. Again, this is a good example of technology that has been around for quite some time that is now being used in new and useful ways.

Approaching obesity from new directions

A company called Modius have created a wearable device that stimulates the eighth cranial nerve, helping people to lose weight.

The Modius brain stimulation headset.

Yes, that might sound like the science fiction I was hoping for, but it is grounded in solid neuroscience.

As we evolved over thousands and thousands of years, we faced starvation at every turn.

Because a lack of food was a constant driving force in our development, our bodies adapted to make it very difficult for us to lose weight.

During prehistory, keeping an extra layer of fat was an excellent way to survive. But, now that we have access to enough food to kill ourselves, holding on to fat is no longer such a beneficial adaptation.

The hypothalamus, deep within the brain, helps decide when and how to lay down fat. The Modius device is able to stimulate one of the cranial nerves that runs fairly close to the surface of the skin, sending a current through to the brainstem.

From there, the stimulation moves on to the hypothalamus, reducing appetite and encouraging the body to move toward a leaner state.

The eighth cranial nerve is also called the auditory vestibular nerve because it plays a role in our sense of balance. According to one of Wired Health’s staff members — who volunteered to try the brain stimulation device — it makes you feel a little dizzy. It’s not unlike the after effect of a glass of wine, apparently.

It can also make the user feel a little sleepy, in the same way that rocking a baby stimulates the vestibular system and makes them woozy.

This is not a miracle cure by any stretch, but for people who find it difficult to lose weight who are active and eating well, this may provide a much-needed edge.

Although the brain stimulation technology is, in this instance, cutting edge, the theory behind it was first uncovered by NASA in 1972, although they didn’t realize it at the time. It took another 30 years to understand that stimulating the vestibular system causes a reduction in body fat.

The take-home message for me this year is one of regrouping. In the past decade, there has been so much innovation that each strand of tech is still waiting to come to fruition.

Today, we see technology that has already been fine-tuned finally being used to benefit global health. It’s an interesting and app-heavy time for medical science.

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Federal Agency Courted Alcohol Industry to Fund Study on Benefits of Moderate Drinking

“This must have seemed like a dream come true for industry. Of course they would pay for it,” he said. “They’re admitting the trial is designed to provide a justification for moderate drinking. That’s not objective science.”

Asked about the meetings, Dr. Mukamal did not deny he had participated, but said the slides did not convey the full complexity of his presentation.

Last year, Dr. Mukamal told The New York Times that he had had “literally no contact with anyone in the alcohol industry in the planning of this.” He defended that statement saying the presentations took place long before the N.I.H. announced the funding grant in late 2015.

The description of the trial that he gave at the meetings was just a “boilerplate,” he said.

“My job there wasn’t to raise money,” Dr. Mukamal added. “It was to educate.”

A Vexing Question

The N.I.H. awards most research funds on a competitive basis, and grant applications undergo a two-tier review of the scientific merit and public import of a project, as well as the scientific integrity.


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At a cost of $100 million, the new trial aims to resolve a persistent medical conundrum. Though excessive drinking is harmful and problem drinking is on the rise in the United States, many observational studies have found that moderate drinkers outlive abstainers and have less heart disease.

These studies don’t prove that moderate drinking is the reason these people live longer, however. The new trial, called the Moderate Alcohol and Cardiovascular Health Trial (M.A.C.H.), is intended to answer that question.

In January, Dr. Mukamal and his colleagues started recruiting volunteers ages 50 and older who are at high risk for heart disease; eventually there are to be 7,800 participants at 16 sites worldwide. Half will be told to abstain from alcohol. The rest, including both men and women, will be told to have one serving of alcohol a day.

No other long-term trial has ever asked participants to drink, much less drink every day. Scientists will track the two groups for six years on average to see whether daily drinkers have fewer heart attacks and strokes, and lower odds of diabetes and death.

The research will attempt to track the risks of drinking, but critics say it may not fully capture the harms. For one thing, the study will be too short to detect an increase in cancers linked to alcohol consumption, which may take decades to develop.

In addition, two servings has long been considered moderate drinking for men. Lowering the threshold may reduce falls, car accidents and alcohol abuse among the subjects; but one drink daily also may not reflect real-life habits.

Moreover, many people whose health might be compromised by light drinking — anyone with a history of addiction, psychiatric, liver or kidney problems, certain cancers or a family history of breast cancer — will not be allowed to participate. People who have never drunk alcohol also are excluded.

“You’re picking off the people who are most likely to have the harms,” said Dr. Richard Saitz, chair of the Department of Community Health Sciences at Boston University School of Public Health, after reviewing the parameters of the study.


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But if the study finds even a modest cardiovascular benefit to light drinking, he added, “You can be sure that the way it will be understood by the general public is that this applies to everybody.”

Despite its shortcomings, M.A.C.H. may well be the last word on the subject of moderate drinking, since trials like these are both expensive and logistically complicated to carry out.


No other long-term trial has ever asked participants to drink, much less drink every day, or encouraged participants to drink whatever they like.

Edu Bayer for The New York Times

Dr. Mukamal, who has published nearly a hundred scientific papers on the relationship between moderate drinking and cardiovascular disease. emphasized in an interview that he was committed to reporting the results accurately based on the data.

“If anyone has any doubt whatsoever that our intent is to provide the most accurate and precise description of our findings, they are sorely mistaken,” he said.

‘They’d Be Happy’

Private contributions for the study from the alcohol industry are being channeled through the Foundation for the N.I.H., a nongovernmental entity that raises money for N.I.H. research and manages the partnerships established to direct private donations.

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In this case, the industry donors were expected to be held at “arm’s length” and not to play any role in the research or to communicate with the scientists, said Julie Wolf-Rodda, director of development for the foundation.

George Koob, the current director of the National Institute on Alcohol Abuse and Alcoholism, said the foundation constitutes an impregnable “firewall” that prevents donors from interfering with research.

In an interview, he said he was unaware of the meetings between N.I.H. officials and industry officials to rally support for the study, most of which took place before he took the helm of the institute in late January 2014. He denied that the institute had solicited funding.

Raising his voice during an interview, Dr. Koob insisted the industry’s sponsorship would not compromise the study and said that the study protocol went through several rigorous reviews. “We do things right at N.I.H.,” he said.


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But his predecessor, Dr. Ken Warren, who helped organize and participated in some of the meetings as acting director of the alcohol abuse institute, acknowledged in an interview that the scientists’ presentations were meant to both “demonstrate to the industry that the study was feasible” and “to determine if they had interest in taking part” as funders.

Questions about moderate drinking and heart disease are important public health questions, Dr. Warren said, and a government trial would be more credible than research “directly funded by an entity such as the alcoholic beverage industry, which could be considered biased.”

Most of the cost of this government trial, however, is being picked up by five of the world’s largest alcoholic beverage makers — Anheuser-Busch InBev, Heineken, Diageo, Pernod Ricard and Carlsberg.

In an interview, Dr. Lorraine Gunzerath, a retired senior adviser to Dr. Warren, took credit for coming up with the idea of reaching out to the alcohol industry for funding.

Clinical trials like this one don’t fall neatly under the mission of the alcohol abuse institute, she said. “We were supposed to be preventing alcoholism, so to spend that kind of money on research for a possible good use of alcohol was something that would never fly,” she said.

But, referring to the alcohol industry, Dr. Gunzerath said, “If we had a clinical trial, and it was a positive result — which we thought it might be, you sort of think you know where it’s going — they’d be happy.”

All the N.I.H. had to do was “make a business case to the industry that it would be to their benefit, even if they couldn’t actually control the trial’s outcome,” Dr. Gunzerath said.

She arranged for the university scientists to address executives at alcohol industry meetings. “If they didn’t like the research team, they would have said no,” she said.


The study was designed not to differentiate between types of alcohol, expecting to find that one serving of beer, liquor or wine each day would be beneficial.

Edu Bayer for The New York Times

It was no secret at the time that Dr. Mukamal and his collaborators “already believed that moderate alcohol is a good thing,” she said. He already had published papers suggesting as much.


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After the scientists’ presentations, which were provided to The Times by Dr. Gunzerath, she would speak briefly to say that “it would be nice if we could get money from the industry,” but explain that funds would have to flow through the foundation.

On Sept. 30, 2013, Dr. Gunzerath sent an email headed “URGENT! Response needed ASAP!” to Dr. Mukamal, inviting him to Philadelphia to address the annual meeting of the Worldwide Brewing Alliance, to get the brewers’ “buy in” and “extra overall funding potential as well.”

“I can make it,” Dr. Mukamal responded. “I could do any version or part or the whole day, night before or drive down that day etc. whatever works best for you.”

Dr. Gunzerath and Dr. Warren also arranged meetings between the scientists and industry representatives at the Distilled Spirits Council’s Washington headquarters on Nov. 21, 2013, and Jan. 28, 2014.

A spokesman for the Distilled Spirits Council said that after the N.I.A.A.A. approached the trade group in 2013, the council “provided them with a forum to present the initial outline of their study.”

Representatives of Anheuser-Busch InBev, Heineken and Diageo confirmed that the scientists’ presentations played a role in the companies’ decisions to underwrite the trial.

“When Heineken was invited by the N.I.H. to partially fund the N.I.A.A.A. trial for a duration of ten years, as part of our decision making process, the scientists presented the research project to us so we would have a sound understanding of the trial,” Michael Fuchs, a company spokesman, said in an email.


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Growing Trend

These days, it is not unusual for the N.I.H. to look to business to participate in public-private partnerships to fund medical research. When an N.I.H. center is seeking outside funding from the private sector, it starts by submitting a “request for collaboration” to a steering committee of the N.I.H. and the foundation based in the office of the director of the N.I.H., Dr. Francis Collins.

For the moderate drinking trial, the alcohol abuse institute signed an agreement with the foundation that said, “Under no circumstances shall N.I.A.A.A. or its representatives communicate directly with any Donor in order to raise funds for the project or to disclose to any Donor any information” about “the name and affiliation of the awardee” or “details and information relevant to the award.”

But by the time the institute submitted the request for outside funding in early 2015, its officials and outside scientists had already met with alcohol industry executives. Representatives of beer and liquor companies had already heard directly from Dr. Mukamal.

The alcohol abuse institute took an extra step to secure Dr. Mukamal’s position as top contender for the grant. While N.I.H. grants are supposed to be awarded on a competitive basis, the institute’s request for outside funding said the award would be restricted to applicants with “unique” resources and backgrounds — and specifically mentioned Dr. Mukamal, who had helped persuade the alcohol industry to fund the research.

Whether scientists studying alcohol should accept money from the industry has long been controversial. Many scientists and policymakers have publicly said that any engagement with the alcohol industry undermines the credibility of the research.

In 2016, a group representing hundreds of scientists and policymakers published a statement saying researchers should never accept direct or indirect industry funding, and that “any form of engagement with the alcohol industry may influence the independence, objectivity, integrity and credibility” of the research.

“We know that industry funding not only affects the results of studies but affects the questions that are asked, how the results are analyzed and what the answers are,” said Dr. Adriane Fugh-Berman, a professor of pharmacology at Georgetown University and director of Pharmed Out, a group that researches drug marketing.

If the health effects of moderate drinking are a priority for the N.I.H., she added, “they should fund it themselves.”

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Tax on millionaires yields big benefits for LA’s mental health services

A statewide tax on the wealthy has significantly boosted mental health programs in California’s largest county, helping to reduce homelessness, incarceration and hospitalization, according to a report released Tuesday.

Revenue from the tax, the result of a statewide initiative passed in 2004, also expanded access to therapy and case management to almost 130,000 people up to age 25 in Los Angeles County, according to the report by the Rand Corp. Many were poor and from minority communities, the researchers said.

“Our results are encouraging about the impact these programs are having,” said Scott Ashwood, one of the authors and an associate policy researcher at Rand. “Overall we are seeing that these services are reaching a vulnerable population that needs them.”

Carl Williams shares his story of braving the cultural stigma attached to mental illness and the positive gains he's made in his life.

Carl Williams shares his story of braving the cultural stigma attached to mental illness and the positive gains he’s made in his life.

Ashley Myers-Turner/KPCC

The positive findings came just a few weeks after a critical state audit accused California counties of hoarding the mental health money — and the state of failing to ensure that the money was being spent.

The February audit said that the California Department of Health Care Services allowed local mental health departments to accumulate $231 million in unspent funds by the end of the 2015-16 fiscal year — which should have been returned to the state because it was not spent in the allowed time frame.

Proposition 63, now known as the Mental Health Services Act, imposed a 1 percent tax on people who earn more than $1 million annually to pay for expanded mental health care in California. The measure raises about $2 billion each year for such services, such as preventing mental illness from progressing, reducing stigma and improving treatment. Altogether, counties have received $16.53 billion.

Los Angeles County receives the biggest share of the money.

Mentally ill inmates who are able to shower, eat, sit quietly and otherwise care for themselves live in a special division in this jail. A psychologist is stationed right outside the room and officers are trained to deal with psychotic episodes.

Mentally ill inmates who are able to shower, eat, sit quietly and otherwise care for themselves live in a special division in this jail. A psychologist is stationed right outside the room and officers are trained to deal with psychotic episodes.

Laura Sullivan/NPR

The money is “critically important” for the community mental health system and for people who need treatment but haven’t been served well in traditional ways, said Toby Ewing, executive director of the state’s Mental Health Services Oversight Accountability Commission. “We can only imagine the challenges we would face if those funds weren’t available.”

Ewing said the recent state audit highlighted problems that need to be addressed. “But at the same time, the vast majority of dollars that have been made available to counties are actually delivering care and services in our communities and these dollars are being spent in creative and inventive ways,” he said.

The funds go beyond the more basic services that counties traditionally provide, helping to pay for workers to reach out to homeless people and triage patients with mental health issues in hospitals, he said.

People come to this mental health urgent care center, across from County/USC hospital, with a range of mental health needs. Some need a refill of their psychiatric medications. Others have been placed on involuntary psychiatric holds and can remain here up to 23 hours.

People come to this mental health urgent care center, across from County/USC hospital, with a range of mental health needs. Some need a refill of their psychiatric medications. Others have been placed on involuntary psychiatric holds and can remain here up to 23 hours.

Rebecca Plevin/KPCC

The Los Angeles County Department of Mental Health commissioned the Rand report, which was based on data from 2012 to 2016. Researchers also interviewed participants in mental health programs.

The report covered two main programs — one for prevention and early intervention of mental illness in young people and another aimed at improving outcomes for people with serious mental illness.

Those who participate in the second program are in and out of jails and hospitals, and really need intensive services, according to Debbie Innes-Gomberg, the department’s deputy director. She said she was pleased Rand found that the services are making a difference. “It is a very good investment,” she said, adding that the county plans to add more participants this year.

Mykael Williams-Wolf holds a piece he made with loose charcoal. LAMP's arts program first started in 1999 and is aimed towards creating a creative space for people who are homeless, living in extreme poverty or have a mental illness.

Mykael Williams-Wolf holds a piece he made with loose charcoal. LAMP’s arts program first started in 1999 and is aimed towards creating a creative space for people who are homeless, living in extreme poverty or have a mental illness.

Maya Sugarman/KPCC

In the future, the county wants to focus even more on prevention for at-risk children by promoting strong familial relationships and stable housing, Innes-Gomberg said. And L.A. County plans to invest more in mental health services in schools. “If on a school campus there is an issue and somebody needs to be evaluated right away, we’re going to be able to develop the capacity to do that across the county,” she said.

She acknowledged that the state audit on unspent funds was fair — and “an opportunity for improvement for counties and the state.”

The audit and the Rand study addressed different questions and are not necessarily contradictory, according to mental health advocates. Sacramento Mayor Darrell Steinberg, who wrote the Mental Health Services Act as a state legislator, said he was “thrilled” about the results from Rand but agreed that “in many counties, the money needs to get out faster because the needs are growing.”

“If we invest in early intervention and prevention, if we invest in whatever it takes for the people who are the most chronic and seriously ill, their lives will be much better and so will our communities,” he said.

Inmates await treatment at the new mental health treatment unit at the California Medical Facility in Vacaville, Calif., Thursday, Feb. 14, 2013.

Inmates await treatment at the new mental health treatment unit at the California Medical Facility in Vacaville, Calif., Thursday, Feb. 14, 2013.

Rich Pedroncelli/AP

One participant told researchers, “I would be dead or a criminal” without the services he was receiving, while another said they helped her accomplish her goal of going one month without being hospitalized for mental health care.

Researchers recommended that Los Angeles County improve its data collection and conduct a cost-benefit analysis of the services.

“There are reasons to be concerned about how maybe the money is being spent or not being spent,” said Rand’s Ashwood. “But studies like ours are showing there are positive things happening from these programs.”

Photo by johnbogeman2 via Flickr Creative Commons

To hear to Take Two’s A Martinez speak with lead author Scott Ashwood, click on the media player above. 

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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Amazon is hiring a former FDA official to work on its secretive health tech business

<!– –> founder and CEO Jeff Bezos.

Amazon’s Grand Challenge team, its equivalent of the Google X lab for moonshot technologies, has made its latest high-profile health care hire.

The company has quietly scooped up Taha Kass-Hout, the former U.S. Food and Drug Administration chief health informatics officer, according to a source with knowledge of the hire.

Kass-Hout will serve in a business development role focusing on health care projects. He will work alongside Amazon Grand Challenge chief Babak Parviz, a former director at Google X who joined Amazon in 2014 as a vice president.

Amazon has remained secretive about its health care ambitions, with a few exceptions.

It did announce a collaboration with J.P. Morgan and Berkshire Hathaway to bring down health care costs and improve quality for its own employees. But it hasn’t said much about how that will work, or who will run it.

Amazon’s Grand Challenge team has also been referred to internally as 1492. Like Google X, it is focused on very big bets that would potentially create a new category for the business. The multi-trillion dollar health sector is a major focus for the group.

Amazon did not immediately return a request for comment.

“Empowering consumers”

Kass-Hout left his previous role at Michigan’s Trinity Health in May of last year, and hasn’t updated his LinkedIn profile since then.

At Trinity, where he served as a senior vice president, his role involved “leadership and oversight over data, analytics and digital health initiatives,” according to his profile.

Prior than that, he worked in senior government roles at the Centers for Disease Control and Prevention and the FDA as its first executive focused on health informatics. He’s also a Harvard-trained physician.

His expertise is in health information technologies and digital health, as well as in navigating government regulation.

Most interestingly, he describes his mission on LinkedIn as “empowering consumers via sustainable health data ecosystems.”

That suggests Amazon might be looking to help consumers get easier access to health records. Both Apple and Alphabet have launched initiatives to help consumers gain access to their medical information, which is currently scattered across various health systems.

It’s a big problem — and a big opportunity for technology companies. More than 250,000 people die every year from medical errors, often resulting from a lack of available patient-data on hospital computer systems. Amazon hasn’t revealed its own ambitions in this space, but CNBC reported that it’s looking at opportunities to push and pull data from legacy electronic medical systems.

Medical experts say that it’s also possible that Kass-Hout will help Amazon through various facets of the regulatory process, especially if it brings new health hardware or software to market.

“It’s not clear either way, but it does at least give them the option,” said Stephen Buck, a former co-founder of GoodRx, which gives consumers a platform for cheaper medicines. Buck did not have any inside knowledge of the hire.

“It’s smart of Amazon to bring in people well versed in health care data and how connectivity is vital to improving results,” he added.

Amazon has various teams working internally on a wide variety different health projects, some of which may never reach production.

For instance, it has teams focused on bringing its Alexa voice assistant to health care, figuring out whether it can disrupt the drug supply chain, and selling medical supplies to hospitals. Amazon Web Services is working to serve its customers in the health care sector with cloud technology, and has a deal with Cerner to help better use their data to make health predictions about patient populations.

In addition to Kass-Hout, Amazon this year also scooped up Martin Levine, a prominent Seattle-based geriatrician with an expertise in innovative care delivery models.

WATCH: Amazon Prime could upend the health-care system

Jeff Bezos, Amazon


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Back to the Health Policy Drawing Board

This drives premiums up, making insurance still less attractive to the healthiest people. That, in turn, causes many to drop out, producing the fabled “death spiral” in which only the least healthy people remain insured. But at that point, private health insurance may no longer be viable, because annual treatment costs for serious illnesses often exceed several hundred thousand dollars.

Most nations have solved this problem by adopting universal coverage financed by taxes. The United States probably would have followed this approach except for a historical anomaly during World War II. Fearing runaway inflation in tight labor markets, the American government imposed a cap on wages.

But the cap didn’t apply to fringe benefits, which employers quickly exploited as a recruiting tool. Employer health plans proved particularly attractive, since their cost was a deductible expense and they were not taxed. Before the war started, only 9 percent of workers had employer-provided insurance, but 63 percent had it by 1953.

To be eligible for favorable tax treatment, companies were required to make their plans available to all employees, which mitigated the adverse-selection problem. People would lose insurance if they lost their jobs, which inhibited labor mobility, but since employment relationships were relatively durable in the postwar years, this arrangement worked well enough.

But after peaking at almost 70 percent in the 1990s, employer coverage began declining in the face of stagnating wages and rising insurance costs. By 2010, only 56 percent of the nonelderly American population still had workplace health plans.

Even so, because more than 100 million Americans still had such plans and were reasonably satisfied with them, the Obama administration opted to build health reform atop the existing system. In addition to allowing people to keep their existing employer coverage, Obamacare expanded eligibility for Medicaid and established exchanges in which people without employer plans could buy insurance.

At the outset, Obamacare had three central features:

• Insurers could not charge higher prices to people with pre-existing conditions.

• Those without coverage had to pay a penalty to the government (the “mandate”).


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• Low-income people would be eligible for subsidies.

The first two provisions were necessary to prevent the death spiral, and government couldn’t mandate insurance purchases without adding subsidies for the poor.

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Despite a bumpy rollout and some frustrations over shrinking choices and rising prices at health care exchanges, Obamacare was working remarkably well by most important metrics. Program costs were much lower than expected, and the uninsured rate among nonelderly Americans fell sharply — from 18.2 percent in 2010 to only 10.3 percent in 2018.

This progress is now imperiled.

The mandate — by far the program’s least popular provision — was repealed as part of tax legislation passed in December 2017. And because economists predict that its absence will slowly rekindle the insurance death spiral, we’re forced back to the policy drawing board.

The most common response has been to call for a variant of the single-payer systems employed by most other countries, which promise dramatic reductions in health costs.

The United States spends far more on health care than any other nation, yet gets worse outcomes on most measures. In part this is because administrative and marketing expenses are much lower under single-payer plans. But by far the most important source of savings is that governments are able to negotiate much more favorable terms with service providers. Virtually every procedure, test, and drug costs substantially more here than elsewhere.

An American hospital stay, for example, costs more than twelve times as much as one in the Netherlands. The single-payer approach also sidesteps the thorny mandate objection by covering everyone out of tax revenue.

A June 2017 poll showed that 60 percent of Americans said the government should provide universal coverage, and support for single-payer insurance rose more than one-third since 2014.

Yet a move to a single-payer system faces the same hurdle that shaped Obamacare: Millions of Americans would resist any attempt to take their employer-provided plans away. And although single-payer health care would be far less costly overall, it would be paid for by taxes — the most visible form of sacrifice — rather than by the implicit levies that underwrite employer coverage.

From a purely economic standpoint, the increased tax burden is irrelevant. It’s a truism that making the economic pie larger necessarily makes it possible for everyone to get a larger slice than before. And because the gains from single-payer insurance would be so large, there must be ways to make everyone come out ahead, even in the short run.


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The Yale political scientist Jacob Hacker, for example, has proposed the introduction of Medicare Part E (Medicare for Everyone), which would allow anyone to buy into Medicare, regardless of age. The program’s budget would be supported in part by levies on employers that don’t offer insurance.

The cost savings inherent in this form of single-payer coverage would lead more and more firms to abandon their current plans voluntarily. Gradually, the age for standard Medicare eligibility also would fall until the entire population was covered by it. The Center for American Progress has now introduced a similar proposal.

It’s critical to realize that there are attractive paths forward. In no other wealthy country do we see people organize bake sales to help pay for a neighbor’s cancer care. We can avoid this national embarrassment without requiring painful sacrifices from anyone.

Robert H. Frank is an economics professor at the Johnson Graduate School of Management at Cornell University. Follow him on Twitter: @econnaturalist.

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You Can’t Frack Without Harming Public Health, New Research Shows

You Can’t Frack Without Harming Public Health, New Research Shows

Study examines over 1,200 peer-reviewed research papers, government reports, news articles

This article orginally appeared in Oil Change International

The conclusion is damning. “All together, findings to date from scientific, medical, and journalistic investigations combine to demonstrate that fracking poses significant threats to air, water, health, public safety, climate stability, seismic stability, community cohesion, and long-term economic vitality.”

arial view of fracked landPhoto courtesy of EcoflightAn oil and gas drilling area in Wyoming. In terms of public health, children and pregnant women are among the groups most at risk from air pollution caused by fracking.

“Emerging data from a rapidly expanding body of evidence continue to reveal a plethora of recurring problems and harms that cannot be sufficiently averted through regulatory frameworks.

“There is no evidence that fracking can operate without threatening public health directly or without imperiling climate stability upon which public health depends.” So concludes a must-read 266-page report published on Tuesday by the Concerned Health Professionals of New York and the Nobel Peace Prize-winning group, Physicians for Social Responsibility.

The report examines over 1,200 peer-reviewed research articles as well as government reports and news articles. The hard-hitting report argues that: “the evidence to date indicates that fracking operations pose severe threats to health, both from water contamination and from air pollution.”

Take water pollution and the vast amounts of toxic waste-water dumped daily underground. “In the United States, more than two billion gallons of water and fracking fluids are injected daily under high pressure into the earth for the purpose of enabling oil and gas extraction via fracking or, after the fracking is finished, to flush the extracted wastewater down any of the 187,570 disposal wells across the country that accept oil and gas waste.”

All of the two billion daily gallons of fluid is “toxic, and it passes through our nation’s groundwater aquifers on its way to the deep geological strata below where it demonstrably raises the risk for earthquakes.”

Air quality does not fair better, either. “In the air around drilling and fracking operations and their attendant infrastructure, researchers have measured strikingly high levels of toxic pollutants, including the potent carcinogen benzene and the chemical precursors of ground-level ozone (smog).”

The report adds: “In some cases, concentrations of fracking-related air pollutants in communities where people live and work exceed federal safety standards. Research shows that air emissions from fracking can drift and pollute the air hundreds of miles downwind.”

I have repeatedly blogged that the science was taking time to catch up with fracking. But there is increasing evidence of harm which cannot now be ignored. The science has caught up.

Dr. Sandra Steingraber, one of the report’s eight co-authors, tells Rolling Stone magazine, which has covered the release of the report:”With fracking, we had six peer reviewed articles in 2009 pointing to possible public health risks. By 2011 we had 42. Now there are more than 1200.”

Steingraber adds: “Fracking is the worst thing I’ve ever seen. Those of us in the public health sector started to realize years ago that there were potential risks, then the industry rolled out faster than we could do our science.”

“Now we see those risks have turned into human harms and people are getting sick,” Steingraber continues. “And we in this field have a moral imperative to raise the alarm.”

One of the main areas of concern is for vulnerable groups of people at risk from air pollution such as children and pregnant women.

“Pregnant women have a major risk, not only themselves but they’re carrying a fetus whose cells are multiplying continuously,” Dr. Lynn Ringenberg, a retired Army colonel and the president-elect of Physicians for Social Responsibility told Rolling Stone. “If those cells get hit by some toxic chemical from fracking, it may not manifest itself for years.”

Dr. Kathleen Nolan, a pediatrician and bioethicist who has worked with one Pennsylvania family near the shale gas fields. “They would see a yellow fog, kind of like a chemical mist coming from the compressor station,” Nolan told the magazine. “Their two youngest children, nine and 11, started having tics where their muscles would go into spasms, those spasms would persist even when they were asleep.”

There is also increasing evidence of harm to shale gas workers “These are killing jobs,” says report co-author Dr. Sandra Steingraber. “We have actually detected benzene in the urine of workers at levels known to raise the risks of leukemia.”

The report concludes with Maryland physician Judy Stone, who says: “Fracking profits go to private industry but the public—families and communities—bear the costs of the many health complications from the drilling.”

She adds: “There is growing evidence of a variety of health problems being associated with fracking. Common sense dictates that drinking and breathing cancer-causing agents will take their toll. The correlation is too strong to ignore, especially when we have other, cleaner energy options.”

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