Home Health Future of Medicare, Atul Gawande,

Future of Medicare, Atul Gawande,

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Future of Medicare, Atul Gawande,

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I’m recovering from the STAT Summit – specifically, recovering from this breathtaking view of Boston from the location. Wednesday evening we had a beautiful view of the rising near-supermoon as dusk fell during the last panel of the day.

But the best view? All your faces. It was so good to see some readers in person – and if not this time, then next!

Atul Gawande and biased algorithms

We are still processing everything that happened at the STAT summit. Some facts to consider:

  • STAT’s Sarah Owermohle quoted one of her favorite lines from Atul Gawande’s book ‘Being Mortal’ in her session with him: “After all, our ultimate goal is not a good death, but a good life until the end.” said. Gawande expanded on that, saying that as life expectancies around the world have gotten longer, it’s important to understand people’s priorities. “Whether it’s wearing a mask or taking chemotherapy for cancer, the questions are the same,” he told the audience. ‘What are you willing to sacrifice? What are you not willing to sacrifice for more time?” Read more.
  • We were privileged to have three physicians at the Summit who spoke out about the moral damage of UnitedHealth Group’s Optum acquiring their primary care practices. They are cited in our ongoing Health Care’s Colossus series. Read more here, or watch an excerpt here.
  • Usha Lee McFarling and Katie Palmer’s Embedded Bias series highlighted the difficulty of distinguishing race from algorithms used to determine patient care. But it’s another thing to hear from a patient who waited an extra four years for a kidney transplant because of the race factor in one of those equations. Hear more from Jazmin Evans and others here.

The doctor who investigates the effect of music on cognition

Earlier this week we introduced you to our STAT Wunderkinds 2024, highlighting some of the brightest young minds in healthcare and life sciences. We also heard about their amazing achievements and inspiring perspectives at the STAT Summit.

Today we bring you a Wunderkind profile: Alex Chern’s mother gave him violin lessons as a child after he was diagnosed with hearing loss. Later, in medical school, while sitting in the Vanderbilt cafeteria, he was surprised to read that a neuroscientist who also had a degree in singing was starting a music cognition laboratory at Vanderbilt.

Now he looks back on that day in the canteen, when everything came together at the beginning of the year. Learn about Chern’s journey to where he is today (which involves a ten-day coma) and his research into the relationship between music, hearing loss and cognitive decline.

Uncovering the exposome

You may be familiar with what a genome or a microbiome is, but do you know what an exposome is? Just as your genome is made up of all the genes that make up you, the exposome is made up of all the chemicals you are uniquely exposed to given your diet, the medications you take, the products you use, and the quality of your water and air. etc.

(And let me, your friendly neighborhood chemist, remind you that literally everything is made of chemicals—you’re exposed to them every day.)

Researchers who recently studied blood from pregnant women developed a way to screen for many more of these chemicals than previously possible, identifying almost 300 of them at the same time. Combined with a test that measured whether neurons were stunted, the researchers were able to determine that many of the mixtures of chemicals were bad for neural development, and that even when individual chemicals were found at low concentrations, the additive effect of them in a mixture was still bad. The research will help identify mixtures of chemicals that we should screen for in the future.

Highlights from the top, from Medicare to crossword puzzles

  • Being in the room for a STAT summit is a very different experience than seeing it virtually. Cerevel Therapeutics Chairman Tony Coles told the audience about his work with the Black Economic Alliance: “This is a very high-profile elected official who said, ‘Tony, I would really support the organization, but it has ‘Black’ in it. . And as a result, I cannot be seen to support anything that includes the word ‘Black’.” That’s a direct quote.” All our breaths were taken away for a second.
  • Former CMS Administrator Don Berwick had a tough conversation with Bob Herman about the future of Medicare. Here it is one of his recordings about the “medical claims ratio” and how people from other countries are in disbelief when they hear how we arrange health insurance in this country.
    Another quote from Don that we at STAT loved was this: “I have to say that on a national level, STAT has been a real treasure, one of those journalistic organizations that is able to actually help people understand what is almost incomprehensible .”
  • We don’t have a STAT Summit Bingo card, but the fact that it took until the second day for GLP-1s to be listed made me think we should! We did have a nice STAT newspaper. It was a print-only one, but you can find the crossword here if you want!

Asian Americans in healthcare are not a monolith

After traveling to both Tokyo and Hong Kong on the same trip last year, I was struck by how shockingly different these two cultures were, even though they are both East Asian countries. But in the US, people of both backgrounds would be categorized under the blanket label “Asian American.”

A new study in JAMA Network Open divides the Asian American category into 40 ethnoracial subgroups to examine who does what jobs in the U.S. health care system. The results show that the umbrella category hides inequalities between different populations, which the authors say harken back to historical imperialism, colorism and other injustices that have resulted in socio-economic inequality.

While Indian and Chinese Americans make up the largest share of Asian American physicians, Cambodian and Hmong Americans are largely underrepresented. Filipino Americans make up more than half of Asian American nurses and nursing assistants, and Bangladeshi and Chinese Americans made up the largest share of home health aides. Overall, Asian Americans represented an estimated 22% of physicians, 10% of RNs, and 8.3% of home health aides.

To learn more about how the Asian American label hides health disparities, read this award-winning piece by my colleague Usha Lee McFarling.

What we read

  • Legal marijuana contains dangerous fungi. States approve it anyway, Wall Street Journal

  • Top HHS official doesn’t think the election will affect AI rules, STAT
  • GLP-1 goes the way of intestinal health, The Atlantic Ocean
  • DA Wallach on the tragic death of his wife and the creation of a ‘golden record’ for medicine, STAT
  • These little worms are worth at least four Nobel Prizes, New York Times

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