Longer Looks: West Va. Comes To Grips with Opioids; Aid In Dying
Each week, KHN's Shefali Luthra finds interesting reads from around the Web.
The New Yorker:
The Addicts Next Door
West Virginia has the highest overdose death rate in the country, and heroin has devastated the state’s Eastern Panhandle, which includes Hedgesville and the larger town of Martinsburg. Like the vast majority of residents there, nearly all the addicts are white, were born in the area, and have modest incomes. Because they can’t be dismissed as outsiders, some locals view them with empathy. Other residents regard addicts as community embarrassments. Many people in the Panhandle have embraced the idea of addiction as a disease, but a vocal cohort dismisses this as a fantasy disseminated by urban liberals. (Margaret Talbot, 5/29)
The Economist:
Before Republicans Replace Obamacare, The White House Is Killing It
Whether or not their bid to reform health care succeeds, Republicans think Barack Obama’s Affordable Care Act will founder. For years, critics of the law have said that its health-insurance markets will enter a “death spiral” in which rising premiums drive out healthy buyers, forcing premiums higher still. “Obamacare is absolutely dead” President Donald Trump told The Economist on May 4th. (5/25)
The Washington Post:
Violence Is Soaring In Parts Of Mexico That Supply America’s Heroin
In this skittish town on Mexico’s heroin highway, civilians with rusty shotguns shake down passing cars for contributions to the public defense. The police were disbanded years ago. The mayor recently got a death threat and fled in the governor’s helicopter. (Joshua Partlow, 5/30)
The New York Times:
At His Own Wake, Celebrating Life And The Gift Of Death
[John] Shields intended to die swiftly and peacefully by lethal injection, administered by his doctor. Last June, the Canadian government legalized what it termed “medical assistance in dying” for competent adult patients who are near death and suffering intolerably from irremediable illnesses. When his doctor, Stefanie Green, informed him that he qualified, Mr. Shields felt the first hope since a doctor told him more than a year before that he had a rare and incurable disease called amyloidosis, which caused proteins to build up in his heart and painfully damage the nerves in his arms and legs. Having control over the terms of his death made him feel empowered over the disease rather than crippled by it, a common response among Dr. Green’s patients. Mr. Shields believed that dying openly and without fear could be his most meaningful legacy. (Catherine Porter, 5/25)
Modern Healthcare:
Behavioral Health: Fixing A System In Crisis
Each year, the nation’s health system spends billions of dollars trying to treat, manage and prevent an array of avoidable conditions that only continue to grow in prevalence. Nearly two-thirds of all deaths annually are attributable to chronic conditions. Patients with chronic conditions account for 81% of all hospital admissions, 91% of all prescriptions filled and 76% of all physician visits. Roughly 86% of the $2.9 trillion spent on healthcare in 2013 was related to chronic disease. (Ross Johnson and Harris Meyer)
The Age:
Anaesthesia: What We Still Don't Know About The 'Gift Of Oblivion'
I am in a smallish, whitish room in a hospital in Brisbane. It is night. On the wall opposite my bed I can dimly make out a crucifix with its limp passenger. Beneath it float wide blank windows through which I watch the synapses of city light: a web of tiny illuminations and extinctions that seem, when I loosen my gaze, almost to form patterns, as if they are about to make sense. I am surprised at how calm I feel. (Kate Cole-Adams, 5/27)
Vox:
Insurance CEO: I’m Raising Obamacare Premiums Because Of Trump
Most health insurance executives will demur when you ask questions about whether the Trump administration is making Obamacare more expensive. Not Brad Wilson. He’s the chief executive of Blue Cross Blue Shield North Carolina, a health insurance plan that just filed a 22.9 percent Obamacare rate increase in 2018. Wilson had hoped to have a smaller rate increase this year; he feels like, after years of losing money, the North Carolina marketplace is finally stabilizing. (Sarah Kliff, 5/30)
The Atlantic:
The Doctor Who Revolutionized Hospital-Birth Safety
Complications like shoulder dystocia are rare in obstetrics. Even when they occur, mothers and babies are overwhelmingly likely to do well. This sounds like a blessing, but it actually has long been the field’s most dangerous curse. Obstetric medicine is like aviation: As even the worst airlines go years without a crash, so can even the most cavalier, careless hospitals go years without a mother or a baby dying or being serious injured. But these rare catastrophes add up: In 1990, the maternal mortality rate in the United States was just over one in 10,000—on par with many Eastern European countries, but about double the rate in the “safest” countries, such as Canada. (Adam Wolfberg, 5/26)
WIRED:
Obesity Surgery May Work By Remaking Your Gut Microbiome
Bariatric surgery comes in a few flavors; there are stomach staples and industrial strength rubber bands. The most successful approach of all—a technique known as Roux-en-Y gastric bypass—is also the most aggressive. But a mounting body of evidence suggests that it may be possible to get all the weight-dropping effects of the procedure without going under the knife at all. Why? Bacteria, of course! (Megan Molteni, 5/26)