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Monday, December 10, 2012

Health Care Reform Articles - December 10, 2012


Let’s Gang Up on Killer Bugs

I hope you never have this experience: a loved one is hospitalized. Her doctors tell you her infection is resistant to antibiotics. She dies. More than 60,000 American families go through that experience each year — and the number is almost certain to rise.
Multidrug-resistant organisms are showing up in top-flight hospitals — like the klebsiella found in the National Institutes of Health’s Clinical Center this year, which may have led to the deaths of seven patients. Even infections that used to be a breeze to treat, like gonorrhea, are becoming incurable.
In much of the world, of course, bacterial disease is a routine cause of tragedy. Tuberculosis alone kills 1.4 million people a year. One reason for this staggeringly high figure is that most people in the world are too poor to pay for most medicines. But another reason is that some strains of tuberculosis bacteria have become resistant to most of the drugs we have. Even after two years of toxic treatment, drug-resistant tuberculosis has a fatality rate of about 50 percent.
What makes the rapid loss of antibiotics to drug resistance particularly alarming is that we are failing to make new ones. We are emptying our medicine chest of the most important class of medicines we ever had. And the cause can be traced, for the most part, to two profound problems.
The first is economic. Historically, the drug industry thrived on antibiotics. But if an antibiotic is useful against only one type of bacterium, relatively few people need it during its patent life. And if an antibiotic is “broad spectrum,” meaning it works on many different types of bacteria, wider use shortens its commercial life because it quickens the pace at which bacteria develop resistance. Moreover, antibiotics are designed to cure an acute disease — not to palliate a chronic one — so people need them only for a limited time. Compared with drugs that are used for years to treat widespread conditions like high cholesterol or asthma, antibiotics pale as a corporate investment.

Worthy battle for homeless ends in victory

Bob Taube sounded like a man who had won a drawn-out battle he never really expected to fight, which is exactly who he is.
Taube runs Boston Health Care for the Homeless, a group that provides medical care in clinics and shelters across the city. It serves about 12,000 patients a year, and has won kudos for its service to a population that is beyond needy.
When the decision was made to renovate an old shelter in Jamaica Plain and turn it into permanent housing, the group thought it had lined up support in the places where it was most needed — the mayor’s office and the Boston Redevelopment Authority.
But Taube’s group ran into opposition from a pocket of well-heeled Jamaica Plain residents who tied the project up in court for two years. The long-running battle ended for good last week when the Supreme Judicial Court refused to take up an Appeals Court ruling backing the project. Finally, the legal battle is over.

Will national health reform close ethnic and racial disparities?


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