5-Star Friday: Trust

By | September 23, 2018

A core value that medicine and journalism share is trust.

In the increasingly complicated world of health care we often have no choice but to place our trust in medical professionals, researchers, hospitals, and state/federal agencies.  One could argue when that trust is violated — as highlighted in many of the stories featured below —  it’s a public health issue.

So when diligent reporters shine a light on such breaches of trust, it’s worth reading about.

Mary Chris Jaklevic | Reporter-Editor

Behind Your Rising Health-Care Bills: Secret Hospital Deals That Squelch Competition • Anna Wilde Mathews • Wall Street Journal

Mary Chris Jaklevic

As a former healthcare finance reporter, I’m familiar with the ways that hospitals have long consolidated power and stifled competition. In this article, Mathews opened even my jaded eyes to strategies that dominant hospital operators are using to obscure their prices and lard their revenue streams. In particular, this story highlights how some hospitals use contract language to block health plans from crafting less-expensive insurance products.

This article doesn’t offer much in the way of solutions — hospitals argue they need certain market advantages in order to sustain themselves. However, it does a service by lifting the veil on questionable practices that contribute to ballooning costs and a lack of accountability for quality care.

Joy Victory Deputy Managing Editor

Black Patients Miss Out On Promising Cancer Drugs • Caroline Chen and Riley Wong • ProPublica

Joy Victory

Earlier this year, ProPublica shed light on how African-American women are significantly more likely to die from pregnancy-related complications than white women. Now they turn their focus to cancer treatments to see if clinical trial participation aligns with who gets what types of cancers most often.

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It doesn’t. As the story explains, 18 of 31 newly approved cancer drugs “targeted cancers that are at least as likely to afflict black Americans as white Americans.” Yet, “on average, only 4.1 percent of patients in those trials were black.” Similar gaps were found for other minority groups, as well.

This lack of representation means that non-white Americans may be missing out on clinical trials that could extend their lives. It also means drugs approved on the basis of these trials may not be as effective for black Americans as we think, because “there’s growing evidence that, whether for environmental or genetic reasons, drugs may have different effects on different populations.”

Michael Joyce | Writer-Producer

Despite Red Flags at Surgery Centers, Overseers Award Gold Seals • by Christina Jewett • Kaiser Health News

Michael Joyce

When I was a student at St. John’s Elementary, gold stars from the nuns were hard to come by. Apparently that’s not the case with surgery centers in California, the only state to use private accreditors as overseers.

State law requires these five agencies to perform “reasonable investigations” and they get paid “about $ 15,000 every three years” … by the centers they are investigating.

Jewett shares stories from a Kaiser Health News investigation that reveal what she calls a “troubling legacy of laxity” in which some centers that received a gold seal from overseers were subsequently found to be grossly negligent by the medical board and other state agencies.

The stories will give you goosebumps (not the good kind) and leave you asking a question we often pose: “Who’s watching the watchdogs?”

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Kathlyn Stone | Associate Editor

More and More, New Drugs Clear the FDA With ‘Accelerated Approval  • by Abigail Fagan & Mark Kaufman • Undark

Kathlyn Stone

Some days it’s hard not to be pessimistic. We know there will soon be another mass shooting. The only questions are — where and when? We also know that climate change will bring more storms and floods to damage our coasts.

Another certainty is that some patients will be harmed by rapid approval of a drug under the FDA’s fast track program. Are the benefits of those accelerated drug approvals worth the harms that we know will occur?

In their article for Undark magazine authors Fagan and Kaufman give us a rundown of why Americans are at risk from the FDA’s addiction to accelerated drug approvals, and examples of where the fast-track approvals have had an undesirable effect. They also explore whether the benefits of fast-tracked drugs are as meaningful as they are portrayed to be.  

At his confirmation hearing last year FDA commissioner Scott Gottlieb gave us insight into how he’d run the agency. All signs were that he’d adopt and expand on the ‘faster approvals are better approvals’ mantra embraced by his predecessor Margaret Hamburg. As the article points out, Gottlieb at his hearing “rejected the idea that speeding up drug approvals would compromise their safety, calling it a “false dichotomy that it all boils down to a choice between speed and safety.”’

Fagan and Kaufman provide compelling evidence that the tradeoffs involved between speed and safety are real, and that we ignore them at our peril.

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Please Note: These stories have not been subject to our rigorous, 10-criteria systematic review for accuracy, balance, and completeness. Rather, they represent pieces of health care journalism and opinion writing that members of our staff found compelling and wanted to share with others.

5-Star Friday is a regular feature on HealthNewsReview.org. You can find a list of previous installments HERE.

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