Closer Look
'Pawns in a very expensive game': Dialysis patients fear coverage changes
Adobe
Almost a year after the U.S. Supreme Court ruled that employer-sponsored health insurance plans could limit outpatient dialysis coverage, the insurance picture still looks murky for people with kidney failure who depend on dialysis machines to do what their kidneys no longer can. Americans with kidney failure are eligible for Medicare coverage, but Medicare pays the dominant dialysis providers DaVita and Fresenius far less than private insurers, prompting fears that employers could make changes to coverage that would increase patients' bills so much that they'd have to skip treatments, which can be deadly.
"The patients are pawns in a very expensive game, and I think the patients are feeling that," said Brent Miller, a nephrologist at the Indiana University School of Medicine. He's working with the Indiana University Medicare Advantage plan to create a health insurance option specifically for people with kidney disease. STAT contributor Carrie Arnold describes the scale of the problem.
science
NIH urged to solve shortage of key research animals
Non-human primates — monkeys like macaques and marmosets — are prized by academic scientists and drug developers alike for their close similarity to humans. But a worsening shortage of the animals endangers biomedical research and public health response to emergencies, warns a new National Academies of Sciences, Engineering, and Medicine report that urges the NIH to take action. Monkeys make up only 0.5% of animal research subjects, but they have had an outsized impact on treatments for conditions such as Parkinson's and sickle cell disease.
China shut off the supply of these animals once the pandemic began. Smuggling problems emerged in Cambodia and alternatives such as organs-on-a-chip have shortcomings. "Now is the time to strengthen the systems we need for non-human primate research — including resource tracking, having an adequate domestic supply of these animals, and further development of new approach methodologies," said Kenneth Ramos, who chaired the committee that issued the report. STAT's Ed Silverman has more.
health
Living in a 'food swamp' linked to higher odds of dying from an obesity-related cancer
You've heard of food deserts, where grocery stores and farmers markets are scarce. In food swamps, fast-food restaurants and convenience stores dominate neighborhoods. A new study calculated the ratio of food swamps and deserts to the grocery stores and farmers markets in U.S. counties, then asked whether deaths from 13 obesity-related cancers were higher or lower from 2010 to 2020, depending on access to healthier food. The odds of dying from obesity-related cancers were 77% higher in counties with high food swamp scores, the ecological cross-sectional study reports in JAMA Oncology. Those counties also had higher percentages of residents who were Black, over 65, and had more poverty, obesity, and diabetes. "Understanding that food deserts and food swamps create toxic environments that disproportionately impact minoritized and marginalized communities is a clarion call to prioritize food justice as an issue of social justice in mitigating obesity-related cancer mortality," a companion commentary says.
No comments