Viewpoints: The promise and perils of prostate screening; Presidential candidates shy away from frank discussion of spending

May 24 2012

CNN: Prostate Cancer Screening's False Promise
After an exhaustive process, the U.S. Preventive Services Task Force has announced its final recommendation on PSA-based prostate cancer screening. It finds that the known harms of screening outweigh the potential benefits for men who have no cancer symptoms. It notes that all screening studies have demonstrated considerable harms associated with screening, but only one major study found evidence that screening saves lives -- and that study has some internal inconsistencies. It showed screening saves lives in the Netherlands and Sweden, but not in five other European countries. Even the positive parts of that study did not show a considerable increase in lives saved (Dr. Otis W. Brawley, 5/22).

USA Today: Editorial: Skipping Prostate Test Can Kill
If you have undetected cancer, the average outcome is irrelevant. Skipping the test can kill you. That logic seems lost on the U.S. Preventive Services Task Force, which recommended Monday that because of its findings, the PSA test should no longer be routinely given to men over 50, as it generally has been for the past two decades (5/22). 

USA Today: Opposing View: Make Informed Decisions On PSA
Amid the many messages you are hearing and reading about screening for prostate cancer, I hope this one stands out most prominently: At best, there is a very small potential benefit from the PSA test and there are substantial known harms (Virginia A. Moyer, 5/22).

Los Angeles Times: It's The Fiscal Future, Candidates
The current generation of American elected officials is preparing to pass along the bill for its profligate spending to our children and grandchildren -; a shameful shifting of the tax burden to people with little or no say in the matter. And what is by far the greatest chunk of our spending? Social Security and Medicare, which already account for more than $46 trillion in liabilities and unfunded promises. ... My hope is that, as the presidential campaign unfolds, Obama and Romney will do something that would be truly radical for politicians: speak the full truth about the financial challenges the country faces and what it will take to solve them (David M. Walker, 5/23).

The Washington Post: The Public Trial Of Justice Roberts
Novelist John Grisham could hardly spin a more provocative fiction: The president and his surrogates mount an aggressive campaign to intimidate the chief justice of the United States, implying ruin and ridicule should he fail to vote in a pivotal case according to the ruling political party's wishes. If only it were fiction. The justice is, of course, John Roberts and the case involves the Affordable Care Act (ACA), a.k.a. Obamacare, which would be affordable only if the Supreme Court upholds the individual mandate requiring all Americans to buy health insurance (Kathleen Parker, 5/22).

Reuters: Who Truly Speaks For Small Businesses?
Everyone knows that small businesses hate President Obama's historic healthcare reform law, right? At least that's what the nation's leading small-business advocacy group would have you believe. Joining 26 states, the National Federation of Independent Business challenged the law all the way to the U.S. Supreme Court in March... Yet while the NFIB claims its multimillion-dollar lawsuit is on behalf of job creators and small businesses everywhere, it's unclear whether small businesses genuinely support the NFIB position (John Stoehr, 5/22).

The Wall Street Journal: ObamaCare Vs. The First Amendment
Maybe the president can recast ObamaCare as a jobs program. So lengthy, complex and intrusive a law cannot help but create massive amounts of work for lawyers. Catholic institutions filed a series of lawsuits yesterday seeking to vindicate their rights under the First Amendment and the Religious Freedom Restoration Act. At issue is the regulation mandating that all employer-provided insurance policies cover birth control, including sterilization procedures and abortifacient drugs, in violation of church teachings (James Taranto, 5/22).

The Wall Street Journal: Catholics In Court
The 12 federal lawsuits filed Monday by 43 Catholic plaintiffs against the Obama Administration's birth-control mandate are a big political and Constitutional moment. The nation's most prominent Catholic institutions are saying that the same federal government they have viewed for decades as an ally in their fight for social justice is now a threat to their religious liberty (5/22).

Arizona Republic: Study Offers Some Hope
Alzheimer's disease is a formidable foe. A terrifying enemy that can take everything you know and leave behind only confusion. That's the human level. On a public-policy level, this disease is equally fearsome. ... So it was a good thing that Congress passed the National Alzheimer's Project Act, which the Obama administration used to develop a plan that includes a $16 million grant from the National Institutes of Health. ... The study will test whether a Genentech-developed drug can prevent onset of Alzheimer's in population genetically predisposed to the disease (5/23).

The Hill: Passing FDA Bill Will Save Lives
This legislation also helps reduce prescription drug costs for consumers by speeding the approval of lower-cost generic drugs. By providing FDA with additional resources to review and approve new generic versions of popular drugs, including expensive biologic products, competition will increase and costs will go down. These provisions will also help FDA address recent problems with drug shortages, allowing it to inspect and approve new manufacturing facilities on an expedited basis and improve FDA's access to information about potential shortages before they happen (Sen. Tom Harkin, D-Iowa, and Mike Enzi, R-Wyo., 5/22).

Philadelphia Inquirer: Pennsylvania Women At Risk Due To Gender Bias, Study Finds
Pennsylvania ranks 32nd among states in women's health, according to a 2010 study. Our numbers are dreadful in terms of breast cancer death rate (sixth), high blood pressure (ninth), diabetes (12th), and smoking (14th). Who knows what will happen to everyone's health if the commonwealth doesn't get serious about environmental regulations related to fracking (Karen Heller, 5/23).

Philadelphia Inquirer: A Healthy Partnership When Traditional Medicine Can't Do It All
At St. Christopher's Hospital for Children, and in similar offices throughout the country, many of the resources our patients need to be healthy are not under physicians' direct control. I can easily write a prescription for an asthma-controller medication but cannot write a prescription to rid the child's home of the many toxins that contribute to a child's worsening asthma. I can refer a child to a mental-health provider but cannot write a prescription to decrease a child's exposure to toxic stressors such as interpersonal violence, bullying, and poverty (Daniel Taylor, 5/23).

Chicago Sun-Times: GOP Should Back Cigarette Tax
Some House Republicans are willing to support another central element of the Medicaid package: a higher cigarette tax. Without it, Illinois will face even more devastating cuts to the state's health-care safety net. Despite that, Senate Republicans remain opposed to the cigarette tax. It's time for them to join the team backing a healthier and more humane Illinois (5/22).

JAMA: Retail Clinics And Drugstore Medicine
Easy access to medical clinics in retail settings is gaining momentum in the United States. While criticized in some quarters, these clinics are successful as measured by patient satisfaction and quality scores. Retail clinics hold potential for a uniquely US solution to the problem of access to primary care. Although questions remain about their future, evidence suggests that retail clinics may have an important role in US health care (Christine K. Cassel, 5/23).

JAMA: Assessing Value In Health Care Programs
Although asking about return on investment might seem to make sense given concerns about health care cost and value, asking about return on investment is the wrong question when assessing whether a health care program is successful. What would happen if the rule were applied to every health care decision that is made? Besides childhood vaccination and flu shots for the elderly, few health care services save money. The positive return-on-investment criterion is not applied to most health care services because almost nothing satisfies it (Dr. Kevin G. Volpp, George Loewenstein, Dr. David A. Asch, 5/23).

JAMA: The Journey Across The Health Care (Dis)Continuum For Vulnerable Patients
Older adults with hip fracture and multiple chronic conditions illustrate the challenges facing vulnerable patients as they move through the health care system. Their journey highlights recent policies that both facilitate and impede attempts to provide appropriate care and suggest gaps that need to be filled to ensure better care and outcomes (Drs. Grace Jenq and Mary E. Tinetti, 5/23).

JAMA: Deciphering Harm Measurement
Improvement in health care quality and safety can be notable when measurement criteria are clear, evidence is strong, and policy and interventions are focused. Despite this potential, progress in reducing patient harm in hospitals has been slow (Gareth Parry, Amelia Cline and Dr. Don Goldmann, 5/23).

Medpage Today: Jim Crow, Old Crow, Al Capone, And Richard Nixon
Recognizing full well that our society has not done a good job regulating either tobacco or alcohol, and that marijuana is not harmless, I nonetheless believe that cannabis cultivation, possession, marketing, sale, and use should now be made legal, regulated, and taxed in all 50 of these United States (Dr. George Lundberg, 5/14).

Medscape Today: A Forthcoming Diabetes Epidemic In Teens?
The National Health and Nutrition Examination Survey (NHANES) is the oldest and largest nationally representative continuous survey of the health and nutritional status of the US population. ... a recent analysis concluded that the prevalence of prediabetes and diabetes in American teens had more than doubled in the 10-year study period, increasing from 9% to a staggering 23%. Medscape spoke with Ashleigh L. May, PhD, from the Division of Nutrition, Physical Activity, and Obesity at the Centers for Disease Control and Prevention (CDC), lead author for this study, about the implications for practice (May and Scudder, 5/22).