News & Information
Pain and Opioid Use in Returning Troops
Written by Editor   
Wednesday, July 02, 2014 08:34 AM

Nearly half of a U.S. Army infantry brigade back home from Afghanistan reported experiencing pain for at least the past 3 months, and 15% said they had used opioids in the past month -- including some who indicated they were not in pain, researchers said. These numbers are much higher than reported in the civilian population and don't appear to correspond exclusively to combat injuries.

The results "suggest a large unmet need for assessment, management, and treatment of chronic pain and related opioid use and misuse in military personnel after combat deployments."

Two physicians with military connections said the findings were worrisome in the context of service readiness.  "The nation's defense rests on the comprehensive fitness of its service members -- mind, body, and spirit. Chronic pain and use of opioids carry the risk of functional impairment of America's fighting force."  The physicians also used the figures provided to suggest that much of the opioid use was inappropriate. Opioids are supposed to be prescribed only for moderate to severe pain, and their balance of benefit versus risk in chronic pain is not clearly positive, the physicians noted.  "We must transform ourselves in the way we manage pain."

Surgeon General: No Longer Relevant?
Written by Editor   
Wednesday, July 02, 2014 08:08 AM

Once "the kings of U.S. public health," surgeons general have seen their powers gutted to the extent that the post should be done away with, according to one expert.  "It's probably time to get rid of the surgeon general." The position is at a nadir and unlikely to rise again in the perennially risk-averse political climate, one author concluded after seven years of research and interviews.  Yet there's evidence suggesting the public health message is just not getting through.

'Big Pharma' Is Now in Insurance Industry Crosshairs
Written by Editor   
Wednesday, July 02, 2014 07:30 AM

The health insurance industry has seen the enemy and it's not big government -- it's big pharma and its ally big hospitals.

This may come as somewhat of a surprise to those who remember predictions of a collapse of the insurance market issued by America's Health Insurance Plans (AHIP, the insurance industry trade group) in the many months leading up to the rollout of the Affordable Care Act.  

For the last few weeks, AHIP has been filling my mailbox (and, I am guessing, the mailbox of every other journalist on its media contact list) with press releases, surveys, and forwarded articles assailing the two-barreled threat of big pharma and big hospitals to the American way of life.

Here's one example:


Trend in Health Spending is Global
Written by Editor   
Wednesday, July 02, 2014 07:25 AM

Other industrialized countries have been experiencing the same variations in health spending growth over the past 30 years as the U.S., a new analysis found, suggesting that the factors driving these ups and downs are not unique to the U.S.

In every period since 1980 during which growth in U.S. healthcare spending dramatically outpaced the rest of the economy, the same thing was happening in most other countries belonging to the Organization for Economic Cooperation and Development (OECD), which represents the world's major industrial powers.

What Is the Public-Private Bridge?
Written by Editor   
Tuesday, July 01, 2014 10:41 AM

Bridging the gap between the U.S. public health system and private healthcare is a key mandate of the Affordable Care Act (ACA) that has gone largely unrecognized.  Few so far have described the potential effects of the this mandate on prevention and public health. The public and private health sectors have operated with very little interaction for almost a century.  The ACA's Prevention and Public Health Fund, or Prevention Fund, aims to change that by calling for alignment, coordination, and integration between the two entities.

"Due to the Affordable Care Act, Medicare is now providing coverage for evidence-based preventive services with no copayments."  "We are testing new payment and service delivery models focused on prevention and population health."

Such collaborative care could be a "game-changer that improves the health of the U.S. population." Better integration may prove to be the most radical change through the Prevention Fund as it will allow public health systems to bill insurers for some services, such as immunization.Coordination between the two systems will mean that private clinical providers will be able to refer patients to community programs.  

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