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Tag: Kim Bellard

Healthcare’s Bridge Fire

By KIM BELLARD

We had a bridge fire here in Cincinnati last week.  Two semis collided in the overnight hours.  The collision ignited a blaze that burned at up to 1500 degrees Fahrenheit and took hours to quell.  Fortunately, no one was killed or injured, but the bridge remains closed while investigators determine how much damage was done.  It is expected to remain closed for at least another month.

Unfortunately, the bridge in question is the Brent Spence Bridge, which is the focal point for I-71 and I-75 between Ohio and Kentucky.   It normally carries over 160,000 vehicles daily, and is one of the busiest trucking routes in the U.S. Over $1 billion of freight crosses each day.  There are other bridges nearby, but each requires significant detouring, and none were designed for that traffic load.

What makes this all so galling is that it has been recognized for over 25 years that the bridge has been, to quote the Federal Highway Administration, “functionally obsolete” – yet no action was taken to replace it.  This most recent disaster was a disaster hiding in plain sight.    

Just like, as the coronavirus pandemic has illustrated, we have in health care.

The Brent Spence Bridge was opened in 1963, intended to carry a maximum of 80,000 vehicles daily.  That had been surpassed by the 1990’s, causing calls to replace it with a newer, bigger bridge.  At one time, Rep. John Boehner, from the Cincinnati area, was Speaker of the House and Kentucky’s Mitch McConnell was Senate Majority leader, yet were not able to obtain funding for the replacement, despite strong support from then President Obama and, in turn, President Trump.   

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In Praise of Unsung Heroes

By KIM BELLARD

Even in this extraordinary year, this has been an extraordinary week.  Last Tuesday we had what many believe to have been the most important Presidential election in recent times, maybe ever.  The week also found the coronavirus pandemic reaching new heights.  That was the week that was.

What struck me, though, is how both our election systems and our healthcare system rely on “ordinary” people to keep them going.  They’ve never been more extraordinary than this year.

The pandemic first impacted voting earlier in the year, during primary season.  Going to the polls suddenly seemed like potentially a life-threatening choice, and working at them practically suicidal.  Dates of primaries were moved, many polling stations were closed, new voting procedures were put into place, and absentee ballots found a new popularity.  And yet people turned out in droves to vote, often standing in line for hours.

President Trump upped the ante by constantly railing against absentee ballots and warning about voter fraud.  Despite this, or perhaps because of it, record numbers of people voted early, in person or by mail.  Several states had surpassed 2016 numbers of voters before Election Day.   Tens of millions more showed up on Election Day.  And, amazingly, Election Day passed with relatively few incidents.

Then the counting started. 

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THCB Gang Episode 31 11/5

Episode 30 of “The THCB Gang” was live-streamed on Thursday, November 5th. Watch it below!

Matthew Holt (@boltyboy) was joined by regulars, CEO of Day Health Strategies Rosemarie Day (@Rosemarie_Day1), medical historian & health economist Mike Magee MD (@drmikemagee), fierce patient activist Casey Quinlan (@MightyCasey), writer Kim Bellard (@kimbbellard), and patient & entrepreneur Robin Farmanfarmaian (@Robinff3). The conversation revolved around the underlying value structures in America, what a Republican Senate looks like for the ACA, and how will the (at the time likely but not certain) Democratic Administration change the narrative around health policy.

If you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

It’s (Cyber)Criminal

By KIM BELLARD

One of the redeeming aspects of crises is that, amidst all the confusion, suffering, and loss, there are usually moments of grace, of humans showing their best nature.  With COVID-19, we’ve seen health care workers working long hours in dangerous conditions.  We’ve seen other essential workers — including not just first responders but also grocery workers, meatpackers, trash collectors, and countless others — putting their own safety at risk so that our lives can go on.  There are heroes all around.

Unfortunately, crises also tend to bring out the worst of our natures.  With the pandemic, those trillions of dollars in play have brought out not just those seeking to profit, but also those looking to profit by breaking the law.   We’ve seen people stealing or counterfeiting stimulus payments, defrauding COVID unemployment payments, getting fraudulent PPP loans, and stealing PPE

And then there are the cyberattacks. 

Last week the federal Cybersecurity & Infrastructure Security Agency, the FBI, and HHS issued a joint alert Ransomware Activity Targeting the Healthcare and Public Health Sector, warning that they have “credible information of an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers.”  I’ll spare you the technical details of the expected attack strategies or suggested mitigation efforts, but I will note that they warned: “CISA, FBI, and HHS do not recommend paying ransom.”

Hospitals could ask Universal Health Services (UHS) about that.  UHS took some three weeks to resume “normal services” after a ransomware attack that hit their 250 U.S. hospitals in late September.  UHS claims thatWhile our information technology applications were offline, patient care was delivered safely and effectively at our facilities across the country utilizing established back-up processes, including offline documentation methods.”   E.g., paper records.

Or they could ask the family of the woman in Germany who died as the result of having to be diverted to another city for her medical emergency because the closer facility had suffered a ransomware attack.  One suspects there may have been other deaths, and other adverse outcomes, due to cyberattacks, and that we can expect there to be more.

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THCB “SPOOKY” Gang: Episode 30 10/29

Episode 30 of “The THCB Gang” was live-streamed on Thursday, October 29th! Watch it below!

Matthew Holt (@boltyboy) was joined by some regulars and this episode was a spooky be a COSTUME PARTY! On this episode were data privacy expert Deven McGraw (@healthprivacy), writer Kim Bellard (@kimbbellard), health economist Jane Sarasohn-Kahn (@healthythinker), CTO of Carium Health Lygeia Ricciardi (@Lygeia), MD & hospital system exec Rajesh Aggarwal (@docaggarwal), policy & tech expert Vince Kuraitis (@VinceKuraitis), and me, THCB’s Editor-in-Chief (@zoykskhan). The conversation had a more spooked tone to it as many of us are worried about the safe transition of power, the safety of voters, the misinformation about herd-immunity, the rising COVID-19 cases, and everything happening in the Senate. What will the results of November 3rd bring for this country?

If you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khanproducer

Can You Say “Chemputer”?

By KIM BELLARD

I learned a new word this week: “chemputer.”   It’s not a new word – it’s been around since at least 2012 — but chances are, unless you are a chemist or maybe a synthetic biologist, it’s not a word you knew it either.   Even if you don’t care about chemistry, biology, or, for that matter, etymology, this is something you might want to pay attention to, because it may end up revolutionizing healthcare. 

The term is credited to Professor Lee Cronin of the University of Glascow.  Back in 2012, when he was first discussing the concept, he told The Guardian: “Basically, what Apple did for music, I’d like to do for the discovery and distribution of prescription drugs.”

Fast-forward most of a decade and a pandemic, and Dr. Cronin and others are closing in on that goal — although they’ve updated their analogy to “Spotify for chemistry.”

I won’t pretend to understand either the chemistry nor the programming involved, but, simply put, chemputers automate the production of molecules – including prescription drugs, such as, for example, COVID-fighting Remdesivir.  CNBC recently profiled activity in the field, spurred by some new papers from Dr. Cronin and Dr. Nathan Collings of SRI Biosciences. 

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Not Just Faxes

By KIM BELLARD

I missed it when it was first announced in Japan, but fortunately the U.S. mainstream media has finally picked up on the story, with articles in both The Washington Post and The Wall Street Journal: Japan’s new Administrative Reform Minister Taro Kono has “declared war” on fax machines, among other paper-based traditions. 

Wait, what?  “Administrative Reform Minister?”  The U.S., or at least the U.S. healthcare system, has to hear about this. 

Mr. Kono is a well known Japanese politician, including stints as Defense Minister and Foreign Minister.  He is thought of as something of a maverick, at least by Japanese political standards.  New Prime Minister Suga installed Mr. Kono in mid-September, making overhaul of bureaucracy a top priority: “Wherever there are problems, I want all of them brought to Mr. Kono for handling on behalf of the nation.” 

Mr. Kono set up a hotline for people to report government red tape, which was quickly overwhelmed with thousands of examples.  It soon reopened.

It didn’t take long for Mr. Kono to start calling for significant changes.  “To be honest, I don’t think there are many administrative procedures that actually need printing out paper and faxing,” he said in a press conference in late September.  “My job is to clear the road of obstructions to allow the Ferraris and Porsches of digital innovation to speed through.”

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A War on Science is a War on Us

By KIM BELLARD

We’re in the midst of a major U.S. election, as well as hearings on a Supreme Court vacancy, so people are thinking about litmus tests and single issue voters – the most typical of which is whether someone is “pro-life” or “pro-choice.”  Well, I’m a single issue person too; my litmus test is whether someone believes in evolution. 

I’m pro-science, and these are scary times.

Within the last week there have been editorials in Scientific American, The New England Journal of Medicine, and Nature – all respected, normally nonpartisan, scientific publications – taking the current Administration to task for its coronavirus response.   Each, in its own way, accuses the Administration of letting politics, not science, drive its response. 

SA urges voters to “think about voting to protect science instead of destroying it.”  They cite, among other examples, Columbia Law School’s Silencing Science Tracker, which “tracks government attempts to restrict or prohibit scientific research, education or discussion, or the publication or use of scientific information, since the November 2016 election.”  Their count is over 450 by now, across a broad range of topics in numerous federal agencies on a variety of topics.   

The SA authors declare:

Science, built on facts and evidence-based analysis, is fundamental to a safe and fair America. Upholding science is not a Democratic or Republican issue.

Similarly, NEJM fears:

Our current leaders have undercut trust in science and in government,4 causing damage that will certainly outlast them. Instead of relying on expertise, the administration has turned to uninformed “opinion leaders” and charlatans who obscure the truth and facilitate the promulgation of outright lies.

Jeff Tollefson, in Nature, warns:

As he seeks re-election on 3 November, Trump’s actions in the face of COVID-19 are just one example of the damage he has inflicted on science and its institutions over the past four years, with repercussions for lives and livelihoods. 

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THCB Gang Episode 27, 10/8

Episode 27 of “The THCB Gang” was live-streamed on Thursday, October 8th! Watch it below!

Matthew Holt (@boltyboy) was joined by some of our regulars: health futurist Ian Morrison (@seccurve), WTF Health Host Jessica DaMassa (@jessdamassa), writer Kim Bellard (@kimbbellard), patient & entrepreneur Robin Farmanfarmaian (@Robinff3), health economist Jane Sarasohn-Kahn (@healthythinker), and fierce patient activist Casey Quinlan (@MightyCasey)! We covered the recent presidential & vice-presidential debates, Trump on steroids, what the future of the ACA looks like, how will virtual care change public health, and more.

If you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan (@zoykskhan)

Attention, Walmart Patients

By KIM BELLARD

When Walmart announced earlier this summer that it was opening an insurance agency to sell Medicare-related products and services plans, I thought, “that’s it?”  When Walmart announced later in the summer that it was partnering (first with Microsoft, then with Oracle) in the bid to buy TikTok, I thought, “well, isn’t that interesting?”  And when Walmart announced a few days ago that it was partnering with Clover Health to offer Medicare Advantage plans, I thought: “it’s about time.”

You know Walmart.  265 million people (worldwide) shop at its stores each week.  Ninety percent of Americans live within 10 miles of a Walmart store.  It is estimated that 95% of Americans shop at Walmart during the year.  In over 200 U.S. markets, it accounts for at least 50% of grocery sales.  It is the fifth largest pharmacy chain by revenue. 

And Walmart has been shaking up healthcare for some time.  Way back in 2006, it introduced its $4 Prescriptions program that upended pharmacy pricing.  In 2008, it started offering in-store retail clinics, initially in partnership with hospitals and now operates on its own

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