Tag Archives: nejm

$150 billion of stimulus headed to health care

Dr. Robert Steinbrook broke down health care’s share of the American Recovery and Reinvestment Act – also known as the stimulus package – in the New England Journal of Medicine. The article also features an itemized list of the health industry’s share of the stimulus.

Steinbrook said the act’s effects would be felt immediately, with some of the biggest winners being the National Institutes of Health and the movement for the adoption of health-related information technology.

“The spending includes $87 billion for Medicaid, $24.7 billion to subsidize private health insurance for people who lose or have lost their jobs, $19.2 billion for health information technology, and $10 billion for the National Institutes of Health (NIH).”

According to Steinbrook, “the economic crisis has allowed the Obama administration to undertake far-reaching health care initiatives that it could not otherwise have launched quickly, if at all.”

Doctor suggests reforms to stop foodborne illness

Writing in the New England Journal of Medicine, Dennis G. Maki, M.D. takes a look at foodborne illness, the sources of recent outbreaks and official attempts to control the food-based spread of pathogens.

Once again, we must ask ourselves how foodborne disease can develop in 76 million residents of one of the world’s most technically advanced countries each year, causing 350,000 hospitalizations and 5000 deaths and adding $7 billion to our health care costs, despite intensive regulation of food production and distribution.

Industrial food production and importation, the American fondness for eating at restaurants and centralized distribution have helped to multiply the damage caused by any single outbreak, Maki said.

Maki suggested several possible measures to combat the spread of foodborne pathogens:

  • Requiring bar codes for all commercial food so its origins and contact points can be quickly and easily traced.
  • Changing the feeding practices of cattle, poultry and swine and reduce reliance on practices like anti-microbial food supplements that may promote the growth of harmful bacteria.
  • Improving hygienic food-preparation practices in homes, restaurants and hospitals and giving local health departments the power and means to monitor these practices.
  • Irradiating high-risk foods because “the CDC has estimated that irradiation of high-risk foods could prevent up to a million cases of bacterial foodborne disease each year in North America.”


Fatal Food: A study of illness outbreaks
Thomas Hargrove of Scripps Howard News Service wrote about foodborne illness outbreaks in a 2007 article for AHCJ. He found that some states did a good job of diagnosing and tracking down the causes of outbreaks, while other states “are virtually blind in detecting outbreaks of food illness.”

NEJM article critical of health reporting

In commentary in the New England Journal of Medicine, Susan Dentzer, the editor-in-chief of Health Affairs and an on-air analyst on health policy for the NewsHour with Jim Lehrer on PBS, takes journalists to task for not properly or fully reporting important health issues.

She starts out by praising some “seasoned reporters who perform thoughtfully even in the face of breaking news and tight deadlines.” But then admonishes the rest: “But all too frequently, what is conveyed about health by many other journalists is wrong or misleading.”

The problem, as she sees it, is that “some distortion is attributable to ignorance or an inability to interpret and convey the nuanced results of clinical studies. And some is due to uncertainty about journalists’ proper role: Is our job to describe the bigger picture, or simply to report what is new?”

She cites a few examples, such as the flap over the risks and benefits of the Vytorin cholesterol pill after clinical trial results were belatedly released by Schering-Plough, which sells the drug. “Some journalists asserted that (the trial) showed the drug had no benefits in preventing heart attacks and strokes – something it certainly did not show, since heart attacks and strokes were not end points in the trial. We will never know the cost of this misinformation in terms of panicked patients or physicians who, perhaps unnecessarily, discontinued use of the drug.”

In response, Trudy Lieberman, president of AHCJ’s board of directors, points out that journalists, particularly those on extremely tight deadlines, are often facing an uphill battle in understanding conveying complicated health issues. “Reporters often told me that they would like to write about gray areas and nuances, but their editors won’t let them because the editors are looking for something jazzy,” she tells Scientific American. “If the nuances are there, they’re jumped to the second page if they’re there at all.”

Dentzer makes some valid points, which are likely to come into greater relief as newspapers cut back on staffing and space for stories.