Friday Five: Veterans, birth, ACA, Politifact, #HealthPolicyValentines

It's back by popular demand! (Okay, maybe only Carmen asked if I was ever going to write another Friday Five, but she's so awesome that she counts as at least ten people.) Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Obama signs vet suicide prevention act Yesterday, President Obama signed the Clay Hunt Suicide Prevention for American Veterans Act, legislation aimed at improving the VA’s mental health care and removing barriers that prevent veterans from seeking treatment for mental health conditions. Death by suicide is particularly high among veterans over age 50. While their wish to end their lives may not be directly related to their service, the VA has a responsibility to care for veterans who qualify for VA care and are in need of it. The VA is notoriously problematic, and I hope that the newly-required external audits built into this Act will keep it accountable. After asking them to do what nearly every other American refuses to do, we continually fail our veterans--this Act is just a fraction of what they deserve.

Birth: Home versus hospital A short literature review by Dr. Rikki Lewis reveals interesting findings about the complexities and controversies surrounding home birth.

  • In the US, home births increased by 29% between 2004 and 2009.
  • Among studies investigating the risks and outcomes of home birth, there is little consistency in patient selection and the necessity of reporting infant deaths after transport to the hospital means that those deaths are reported as hospital deaths rather than deaths at home.
  • Policies for deciding to take a woman laboring at home are much clearer in the United Kingdom than in the US.
  • Home births are far less expensive than hospital births, which average about $20,000.

As the hospital versus home birth debate continues, it will be important to use correctly interpreted research as the basis for argument.

ACA open enrollment ends on Sunday The last day to sign up for insurance through the Marketplace is Sunday, February 15. According to the awesome website ACAsignups.net 10.5 million people have already signed up. Originally, the Department of Health and Human Services estimated that 13 million people would receive coverage during the open enrollment period, but later readjusted the estimate to between nine and ten million. If you need insurance and haven’t signed up, do it now...don’t procrastinate! (Also, can we take a moment to wonder why the “marketplace.gov” doesn’t redirect to healthcare.gov? Missed opportunity!)

 

Politifact takes on measles and vaccines One of the best, most useful sites ever, Politifact, evaluated the truthfulness of public statements about measles and vaccines. While their website could use a redesign to make articles like this one easier to read, the information they’ve provided is really valuable. They’re successful in debunking the “vaccines have mercury” claim and Rush Limbaugh’s accusation that Obama’s immigration policy allowed measles to enter the United States through Mexico. Politifact also highlights some of the true statements made by Megyn Kelly and other cable news pundits. While you’re reading their website, take a look at their ratings of statements about health care in general.

Health policy nerds love bad jokes Valentine’s Day isn’t only about romantic love. It can also be a time for you to express your deep, abiding passion for one of the nerdiest arms of public health: policy. Back in 2011, Emma Sandoe started the hashtag #HealthPolicyValentines so we could enjoy gems such as:

and

Groan worthy? Maybe, but totally great anyway.

Have an awesome Friday. I'll be back here tomorrow with a Valentine's Day-themed post!

STEM research & Obama's budget proposal

STEM research and Obama 2016 budget proposalYesterday, I wrote about new data showing that medical research funding has not increased significantly since 2004. Because of the ever-rising cost of research, flat funding levels are worrisome--because of this funding plateau, we may not have the advanced treatments that could save or improve lives available to us as our population ages. Moreover, the United States is on its way to being surpassed in innovation by other countries funding research more vigorously. The Pew Research Center for Internet, Science, and Techonology released a report late last week examining the beliefs the public and scientists hold about STEM (science, technology, engineering, and medicine) research. Using representative samples of the public and of members of the American Association for the Advancement of Science, Pew delved into the nitty-gritty of individuals’ attitudes about science and its role in society. Especially for public funding, these views are important to consider because government funding options are influenced by voters and the political environment. (The report is rich and full of fascinating statistics, most of which I won’t be able to address here, so I recommend reading it in full at your leisure.)

Public perception of research funding

Just over 70% of Americans believe that government investment in engineering, technology, and basic science research will pay off eventually. About one-quarter say that the outcomes are not worth the investment. However, only 61% of the public supports government investment in STEM research. Over one-third have faith that private investment alone will be enough to progress STEM.

There seems to be little difference between Republicans (and right-leaning independents) and Democrats (and left-leaning independents) in beliefs about the importance of STEM research. Younger people tend to value investing in research more than Americans over age 65.

Scientists’ perception of research funding

About half of scientists surveyed believe that this is a good time for STEM, a notable decrease from 76% in 2009. Scientists are slightly more positive about their own fields, however, with 62% saying that now is a good time for their specialty.

The negative perceptions may be influenced by attitudes surrounding the funding process. More than eight out of ten scientists assert that obtaining federal research dollars is more difficult today than it was in 2009. Nearly half report that getting funding from industry and foundations is also more difficult. And scientists are in nearly total agreement (88%) that lack of funding is a serious problem for the ability to conduct high quality research.

Obama’s budget proposal for 2016

If most Americans believe that funneling money into STEM research is an important investment, why do most scientists feel that federal funding is difficult to obtain? President Obama released his budget proposal--let’s see what it has to say about funding research.

This table highlights just a few key areas relevant to STEM research funding and compares their proposed funding to the funding of other, unrelated program areas in the budget. Rows with red text represent STEM research funding.

Funding Area Proposed budget allocation
Special education $12.5 billion
Science and research laboratories $12.8 billion
NASA $18.1 billion
Health research and food safety $37.5 billion
Veterans health care $66.7 billion
Medicare $589.7 billion
National defense (including personnel, operations, equipment, and supplies) $615.5 billion
Social Security $944.3 billion

STEM research is funded at a much lower rate than the budget behemoths Medicare, Defense, and Social Security. One could argue that if we didn’t need or want to spend so much money on these areas, we would be able to fund more research. However, in the case of Social Security and Medicare, the United States has made a commitment to its citizens to provide health care for selected populations and financial support to those who have earned it. These costs are somewhat non-negotiable.

Political cartoon Obama budget

Whether these funding levels are sufficient for STEM research is not something on which I can meaningfully comment. But if researchers feel like they aren’t being funded well enough, and the American public values STEM investment, I have to wonder whether the United States is providing funding on the levels that the American public would prefer.

Without developing new technologies and advancing our understanding of medical science, we will soon be less innovative than other countries and will not produce the health breakthroughs we so desperately need. If we aren’t properly funding this research, we are the ones who will suffer.


Note: My views do not represent the views of any person or any entity associated with the National Cancer Institute, the National Institutes of Health, the United States government, or anything else. These ramblings are mine and mine alone.