Interpretation Only Genetic Services

Technology Review: "How a Wiki Is Keeping Direct-to-Consumer Genetics Alive".

The big question is whether regulators will attempt to shut them down:

Now a question is whether Promethease and sites like it could, or should, be the next target of regulators. Lennon believes his service is outside the FDA’s reach, because it doesn’t offer a spit kit or perform DNA tests itself but instead operates like a “literature retrieval service,” presenting a version of what’s in the science journals. Regulate us, says Lennon, and you’d have to shut down WebMD and Wikipedia, too.

Reached by MIT Technology Review, the FDA said it has authority to regulate software that interprets genomes, even if such services are given away free. The agency does not comment on specific companies.

Also important:

For now, consumers have to fend for themselves in a thicket of scientific information—and make their own decisions about risks.

Hsieh Forbes Column: Why You Should Be Concerned But Not Fearful About Ebola in NYC

My latest short post for Forbes discusses, "Why You Should Be Concerned But Not Fearful About Ebola in NYC".

This is obviously a rapidly-moving story.  But for now, NYC residents (and all Americans) should remain vigilant but not indulge in panic.

Quick Links: ACO Failures, Ebola Lessons

Wall Street Journal: "ObamaCare’s Failing Cost Control; The law’s ‘accountable care’ experiment is a bust so far."

Scientific American: "How Did Nigeria Quash Its Ebola Outbreak So Quickly?"

Health Care Cartels

Nice column in USA Today on how, "Health care cartels limit Americans' options".

The authors Thomas Stratmann (George Mason Univ) and Darpana M. Sheth (Institute for Justice) criticize the "Certificate of Need" (CON) laws that restrict health providers from installing new equipment without government approval.

I previously worked in a state that had CON laws  I was told that my radiology chief had clout with the CON regulators, our department could pretty much get first approval for any new technology.  But I felt bad for the other local doctors who wanted to offer such services (and their patients who might have benefitted), but who didn't have such clout.

Fortunately, my current state of CO doesn't have such CON laws.

D4PC Interviews Dr. Beth Haynes

Docs4PatientCare has a radio show, "The Doctor's Lounge".

Here's their 9/25/2014 interview with Dr. Beth Haynes of the Benjamin Rush Institute:

Join Dr. Scherz and his guest Dr. Beth Haynes, the executive director of the Benjamin Rush Institute. We discuss the need to give young doctors in medical schools the perspective regarding healthcare that they don't receive from their instructors regarding free market solutions to healthcare delivery. This is the mission of BRI and we tackle the challenges she has encountered trying to fulfill this mission.

You can listen at this link.

The Legality of Quarantines

Slate: "The rules and regulations on confining people who’ve been exposed to Ebola".

Quaranting people with serious contagious diseases is a legitimate function of government.

UK Health Strike

Labor unrest in the UK government-run health system: "Why we’re striking: NHS staff on their decision to walk out".

NHS staff in England will stage a strike on Monday in protest at a third year without a pay rise – their first over pay in more than three decades. More than 450,000 people, from cleaners and porters to ambulance drivers and occupational therapists, will be involved in a four-hour walkout.

Not Easy To Opt Out of ObamaCare Mandate

Politico reports that it will be, "A maze to opt out of Obamacare individual mandate":

Tens of millions of Americans can avoid the fee if they qualify for exemptions like hardship or living in poverty, but the convoluted process has some experts worried individuals will be tripped up by lost paperwork, the need to verify information with multiple sources and long delays that extend beyond tax season.

Some gory details:

The uninsured have two ways to opt out: The easiest way is fill out a new tax form for those exemptions that don’t require Obamacare marketplace approval. Some will be simple, including the exemption for being uninsured for under three months or those living below a certain income — about $10,150 for singles and $20,300 for married couples.

But many must be approved by the marketplace, including for people citing religious beliefs, like being Amish, or those who qualify for the dozen or so “hardships,” such as being evicted, experiencing domestic violence or having a health plan canceled because it doesn’t meet the law’s requirements.

There’s even one for being in jail, another for having medical debt and one for taking care of sick family members. An open-ended “hardship” exemption lets people try to explain situations not listed that stood in their way of coverage.

That’s where things get complicated. For marketplace approval, applicants must fill out an exemption application, gather proof of their situation, mail it off and wait a few weeks for approval.
Once they get the exemption certification number in the mail, they then fill out a newly drafted tax form to skirt the penalty.

Some math may be required: If the exemption covers only a few months of the year, the individual is responsible for calculating how much of the penalty he or she will owe...

So just think of all the "fun" you have every April 15 preparing your taxes.  And double that!

Firestone Success Vs. Ebola

NPR reports, "Firestone Did What Governments Have Not: Stopped Ebola In Its Tracks".

From the article:

Harbel is a company town not far from the capital city of Monrovia. It was named in 1926 after the founder of the Firestone Tire and Rubber Company, Harvey and his wife, Idabelle. Today, Firestone workers and their families make up a community of 80,000 people across the plantation.

Firestone detected its first Ebola case on March 30, when an employee's wife arrived from northern Liberia. She'd been caring for a disease-stricken woman and was herself diagnosed with the disease. Since then Firestone has done a remarkable job of keeping the virus at bay. It built its own treatment center and set up a comprehensive response that's managed to quickly stop transmission. Dr. Brendan Flannery, the head of the U.S. Centers for Disease Control and Prevention's team in Liberia, has hailed Firestone's efforts as resourceful, innovative and effective...

You can read more details (or listen to audio) at the link.

Hsieh Forbes Post: Did Bad EHR Lead to Ebola Patient Being Sent Home

My latest quick post for Forbes, "Did Bad EHR Software Lead to Ebola Patient Being Sent Home?"

Short answer: Maybe, maybe not.  The Dallas hospital first said "yes", then "no".

Thanks to Monica Hughes for allowing me to quote her and Dr. Matthew Bowdish for first bringing this story to my attention.

Related: "The Eyes of Big Medicine: Electronic Medical Records" (PJ Media, 8/18/2013) and "Can You Trust What's In Your Electronic Medical Record?" (Forbes, 2/24/2014)