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Healthcare

#ConsumerChoice: Mental Health

At a time when NHS dental services are in crisis – and A&E, ambulance and nursing services are the focus of industrial action due to pay and conditions adding extra strain on the workload – protecting and supporting the mental health of staff in the workplace must become a priority.

A spokesperson from the Consumer Choice Center reports from an event in Switzerland that aims to address the situation.

As world leaders gather in Davos, Switzerland, the Consumer Choice Center hosted a panel on the importance of mental health support. Speakers discussed how challenges to mental health are increasing after the COVID-19 pandemic, the war in Ukraine, and economic uncertainty, and focused on effective coping techniques.

The “Prioritising Mental Health in Times of Global Crisis” panel was moderated by Jillian Melchior, editorial board member at The Wall Street Journal, with opening remarks by Kathleen Kingsbury, Opinion Editor at The New York Times.

Kingsbury told her audience: “Journalists are no strangers to stress, anxiety and trauma. Just last week we lost a reporter in the newsroom, Blake Hounshell, after a long battle with depression.

Read the full text here

Improving America’s Teeth

When was the last time you went to the dentist? If you’re now opening your calendar to check your last appointment, chances are it has been too long. There is no general rule on the regularity that will apply to all patients, not least because we all have different lifestyles. That said, if you are someone who consumes tobacco, drinks alcohol regularly, or if you are in doubt about whether your daily oral hygiene is up to standards, a good rule of thumb is to make a dentist appointment every six months.

For many Americans, the rudimentary costs of seeing a dentist for a routine checkup are manageable. Despite the fact that most dental plans cover 100% of the costs for preventive visits, many Americans appear to lack awareness of their benefits. Even though 80% Americans have access to dental benefits, nearly 35% of adults didn’t visit a dentist in 2019, according to the National Association of Dental Plans. For both the 20% of Americans who are either not employed or whose employer’s chosen insurance plan doesn’t cover dental care, and the existing insured patients, it would be important to increase competition through subscription models. My colleague Yaël Ossowski has explained the advantages of such subscriptions in the Boston Herald.

Improving America’s oral hygiene doesn’t just happen through the policy level of increasing competition or, as some argue, through getting the government more involved in the field of healthcare. First and foremost, oral hygiene happens at home through brushing and flossing. Unfortunately, that is where some Americans’ habits are falling short.

A 2021 study commissioned by the American Association of Endodontists showed that 21% of respondents failed to brush their teeth in the morning, 23% never floss, and 28% didn’t schedule a dental appointment the entire year. A 2016 analysis of 5,000 men and women had found that 32 percent of Americans never floss. This is all paired with headlines of less representative surveys showing that Americans mostly only brush once a day, if at all.

A factor that is underestimated by many is the effectiveness of chewing sugar-free gum. The American Dental Association says that while chewing sugar-free gum is no substitute for brushing your teeth, those gums sweetened by non-cavity-causing sweeteners such as aspartame, xylitol, sorbitol or mannitol can help prevent tooth decay. The saliva produced through chewing washes away food debris and neutralizes acids, and also carries with it more calcium and phosphate to help strengthen tooth enamel.

The European Food Safety Authority (EFSA), known for its cautious assessments of product claims, seconded the assessment that sugar-free gum improved tooth mineralization and thus has overall oral health benefits. It remains important to reiterate that sugar-free gum is in no way a substitute for regular oral hygiene; however, it is an adjunct to oral hygiene that makes it more than just a lifestyle but in fact, a wellness product.

Oral hygiene is an important factor in our daily lives. Tooth decay and lasting problems with teeth plague many Americans, burdening them with high dental costs. Both on a policy level and on an individual level, a lot remains to be done to improve the oral health of all citizens.

Originally published here

Oral health: household solutions for long-term benefits

As continuous lockdowns all over Europe require consumers to spend more time at home than ever before, many of them fall victim to complacency about exercise, and struggle to find focus in a working-from-home environment. Countless articles have already outlined tips for staying healthy while working in home offices. That said, there is a health tip consumers underestimate, and that is easier to put in practice than installing a Peloton next to your office desk: sugar-free gum.

The effects of sugar-free gum (SFG) have been analysed for a long time already. A 2011 study found that chewing gum reduces the desire for snacks by 10%, which makes a significant dent in cravings for those foods that are unhealthy. On top of the widely known added benefit of preventing tooth decay between regular dental hygiene, it has also been shown that chewing gum leads to increased cognitive performance and productivity. Given that consumers, as much as many others, currently spend their days on Zoom calls, chained to our desks, sugar-free gum has been one of many practical solutions that can help us snack less and be more focused. Sugar-free gum has also been mentioned as a tool for keeping anxiety induced by isolation during lockdowns at bay, and is prescribed by surgeons for post-surgery recovery.

Outside of the effect of staying more focused and not stuffing yourself with crisps, sugar-free gum also has benefits in the realm of oral hygiene and dental care. A recent King’s College London review analysed eight papers on the matter, in the attempt to answer the question: “What is the difference in the level of plaque quantity, in adults and children who chew sugar-free gum (SFG), compared with those who do not chew SFG, who do not chew gum or who use alternatives such as probiotics or fluoride varnish?” The review, published in a special edition of Frontiers in Oral Health & Preventive Dentistry, found evidence that SFG reduces dental caries. 2021 research data has previously indicated that Streptococcus mutans, which are a significant contributor to tooth decay, are reduced by chewing.

These evidence indicators have led the UK’s National Health Service1 to address SFG in its guidance on oral health. As evidence becomes more conclusive on the benefits of SFG, consumers should look out for the product as more than just a sugar-free candy replacement, but more as a practical health addition. This could have benefits not merely for individual oral health, but also to overall public health: research published in the British Dental Journal (BDJ) has shown that if 12-year-olds across the UK regularly chewed sugar-free gum after eating or drinking, it could save the NHS £8.2 million, the equivalent of 364,000 dental check-ups.


  1. specifically the Department of Health and Social Care, the Welsh Government, the Department of Health Northern Ireland, Public Health England, NHS England and NHS Improvement and with the support of the British Association for the Study of Community Dentistry.

Is Now the Time to Improve Canada’s Healthcare System?

Guest Host David Clement welcomes economist Ash Navabi and secondstreet.org President Colin Craig for an honest assessment of Canada’s fragile front line healthcare system and whether a private healthcare option might actually help.

Reckoning with insurance for better patient choice in healthcare

A new Senate bill seeks to take the hassle of dealing with healthcare companies away from patients and into the hands of insurance companies. Although it falls short of the mark, this bill is a step in the right direction toward sensible healthcare reform in Pennsylvania.

Regardless of your job, your income, or where you live, we’ve all had at least one nightmare scenario when it comes to health insurance.

There are forms, claims, reimbursement requests, schedules, and negotiations. Doctors, dentists, and health practitioners understand the burden, and often have to face their own bureaucratic tests of will before focusing on their patients. The growth of healthcare administration costs emphasizes this. And that’s for people with private plans.

The price inflation that comes with the amping up of health insurance plans in our entire system — not to mention the role of government subsidies — is a well-known phenomenon. Insurance becomes involved in every rudimentary doctor visit or procedure, leading to bad incentives for health providers, employers, and insurance companies. This process involves a middleman in what should essentially be a simple medical contract between patient and practitioner. 

The answer, however, is not in abandoning free exchange in healthcare, as Medicare For All proponents would have us believe, but rather it is in reckoning with insurance to make our system more competitive and fair.

In Pennsylvania, one particular bill is addressing the process of making insurance more accountable and lowering patient costs and headaches.

This session, State Sen. Judy Ward has introduced SB850 that would enact assignment of benefits reform, compelling insurance companies to follow a patient’s wish to directly pay healthcare providers rather than leaving them with the paperwork and negotiation. This would simplify life for patients by requiring insurers to pay providers directly.

One would think this is standard practice, but especially for dental insurance, there are additional steps and vetting that often leave patients responsible for paying their dentists only after the insurance company has paid out the claim.

Though only a small reform, and leagues from where we need to be to have a truly free market in healthcare decoupled from our employers, this bill would make the entire process simpler and better empower patients and consumers.

Since the Affordable Care Act and large Medicare reforms at the federal level, assignment of benefits is recognized in most medical insurance markets, but not yet for dental patients.

These reforms are complicated by the often cumbersome terms of dental insurance contracts: only portions of care or procedures can be covered by insurance, there are caps on the amounts one can reimburse in a single year, and dentists must navigate these steps to accurately bill their patients without producing a shocking bill. This balanced billing approach is necessary for any medical professional who wants to stay in business.

The answer, however, is not in abandoning free exchange in healthcare … but rather it is in reckoning with insurance to make our system more competitive and fair. 

But the status quo often makes it more complicated than it otherwise would be.

That is why price transparency remains an important principle for these debates, and why legislators should continue ensuring patients have choice and access to the information they need.

There are dozens of easy reforms state legislatures could follow that would help improve care: fostering innovation, reducing bureaucracy, giving incentives to patients to use direct-to-consumer options, and more.

By continuing to promote competition and transparency, patients and consumers can benefit from better care and lower costs. It is only a small degree of change we need, but it beats the alternative.

Originally published here

Simplify insurance for better health care

It is an unfortunate fact that most everyone has a health care insurance horror story.

In our overly complex and convoluted health care system, even routine checkups and minor appointments sometimes snowball into bureaucratic exercises of patience and will. While we thought health insurance would solve these issues, for some it has been made worse.

Whether at the primary care doctor, the dentist or the eye doctor, our reliance on insurance means that a simple transaction between patient and provider can often become complicated. For those without stellar plans, they must pay for care, then submit a claim to the insurer, negotiate the costs, wait for reimbursement and forward that payment to the provider. And that’s assuming the insurance company accepts the claim.

And while reform has been attempted at all levels of government, however well-intended, these have often served to further complicate the issues that come with being a patient in the American health care system, all the while giving more power to insurers.

At least one measure of progress can be found in a bill being pushed through the Pennsylvania Senate that would radically simplify the insurance process for dental patients.

State Sen. Judy Ward, R-Blair, and others have introduced a bill, SB850, that would enact what is known as assignment of benefits reform, requiring insurers to follow enrolled patients’ requests that the insurer directly pay a patient’s health care provider. There would be no additional forms, no additional waiting, and it would simplify the process so that patients could focus on getting what they need, rather than chasing an insurance claim.

This sounds intuitive, but at present, many dental insurance reimbursements must be vetted by the insurance company and then routed to the patients to pay their dentists. Not to mention any clauses found in insurance contracts that add additional steps.

If we were to simplify this process and empower patients, it would do wonders to improve care in this state — and perhaps free up at least one part of our health care system.

Critics of these reforms say they would put pressure on insurers, who would need to simplify and quickly pay health practitioners when patients tell them.

But conceding that point would mean allowing health insurers — who already have a dominant role in the health care industry — to complicate the process of reimbursing patients and providers with burdensome clauses and exemptions in their contracts.

After the Affordable Care Act and several Medicare reforms, assignment of benefits is a standard practice in general health care but so far does not exist across all medical categories. Passing this bill and getting it to Gov. Tom Wolf’s desk would be a strong measure of support for consumers and patients.

Of course, this level of legislation is far from the the large-scale reform needed. An eventual decoupling of insurance from dental and primary care for a more direct-to-consumer model altogether would be a radical way to improve our system, but this bill is a step in the right direction.

These laws have already been passed in states such as South Dakota, Colorado and West Virginia and are trending across the country, but more will be needed.

Indeed, there are plenty of easy reforms state legislatures could enact that would help improve care: fostering innovation, reducing bureaucracy, giving incentives to patients to use direct-to-consumer options and more.

Tax-saving accounts for education have been widely successful, and we could do more with health savings accounts even at a state level. Here, there is a role for government.

If we can continue to promote competition and transparency to provide better care, then patients and consumers will benefit. There are many patients and consumers with great plans that serve their needs. Nevertheless, there are still millions of Americans who want a better process.

Let us hope the Legislature understands this key point and helps make our health care easier, more affordable and pain-free.

Originally published here

Why Covid lockdown might be bad for our dental health – and the unlikely solution

By now, we are all well-versed in the health problems associated with Covid-19. But the knock-on effects in other areas of healthcare are only beginning to become clear more than a year after lockdown became the new normality. From difficulties faced by cancer patients to the mental health consequences of being confined to our homes, the fallout from the pandemic has been deeply harmful in a whole range of areas.

But one of those areas has been largely neglected so far. The effects of Covid and lockdown on our dental health have been almost entirely absent from the public forum. Thanks to the cancellation of practically all non-emergency healthcare in order to focus finite resources on fighting coronavirus, the normal routine of regular check-ups and quick diagnoses has disappeared, which could have a very serious effect in the longer term.

As a result, a vast array of minor oral health conditions have probably gone unnoticed in the last year. They have therefore been allowed to fester and when they are eventually discovered once normal healthcare service has resumed and they have to be treated, much more serious and extensive procedures might be required.

The problem goes far beyond your teeth. Countless serious medical conditions start in the mouth and are first picked up on by dentists. Periodontitis, for instance, is a bacterial inflammation of the gum tissue which can cause bleeding. If left untreated, periodontitis can go on to cause other serious issues in a domino effect when that bacteria contaminates the bloodstream. Heart valve infections, abscesses and even life-threatening sepsis, which sometimes causes damage to multiple organ systems, can all come about because of an unaddressed problem in the gums.

Present this information to a politician – especially one in the current government – and their response would be quite predictable. On health policy, Boris Johnson’s nominally Conservative government has embraced the interventionist doctrine of the nanny state. Tax this, ban that. From advertising restrictions to sin taxes, ministers’ instinct when they identify what they deem to be a public health problems seems to be to interfere.

But the hidden dental health pandemic is a perfect example of why the free market, not the state, is best placed to tackle these kinds of problems. Cutting-edge scientific research is suggesting that the simple act of chewing can single-handedly solve a great deal of oral health problems, meaning that a product as simple and innocuous as sugar-free chewing gum might be a silver bullet to this whole category of issues.

When you chew, you produce saliva, which has myriad positive consequences including rebalancing the pH in your mouth and churning out countless healthy minerals like calcium and phosphate ions. Chewing sugar-free gum has other positive effects, too, from helping people quit smoking to reducing appetite, resulting in less snacking and therefore weight loss.

In other words, pioneering research is showing us that accessible, everyday products which are already on the market can address underlying public health concerns, without the disadvantages of a clattering intervention from the state.

The government likes to talk up post-Brexit ‘Global Britain’ as a world leader in scientific research. If that is to be the case, it’s time to abandon the nanny state mindset and allow the free market – and our world-class universities and research institutes – to take up their rightful place on the front line of any and all public health battles. In the case of dental health, that is already happening – let’s just hope the government don’t take it upon themselves to interfere.

Originally published here.

The global organizations and populists who aim to seize COVID vaccine tech and IP

When Donald Trump claimed in September 2020 that every American would have access to vaccines by April 2021, his comments received scorn. The Washington Post said his claims were “without evidence,” CNN quoted health experts who said it was impossible, and The New York Times claimed it would take another decade.

Now, a year into this pandemic, nearly half of the eligible population has received at least one vaccine dose in the U.S., and distribution has been opened to every American adult.

Operation Warp Speed, which invested tax dollars and helped reduce bureaucracy across the board, has contributed to what has truly been a miraculous effort by vaccine firms.

While Trump’s proclamations eventually become true and the question of vaccine ability has been settled, there is now pressure on the Biden administration to turn over domestic vaccine supply to countries with skyrocketing cases.

On Sunday, the U.S. declared it will send additional medical supplies to India, currently experiencing the largest global spike in cases.

But at international bodies, countries and activist groups are petitioning for far more: they want to force biotech companies to waive intellectual property rights on vaccines and COVID-related medical technology.

Along with nearly 100 other countries, India and South Africa are the architects of a motion at the World Trade Organization called a TRIPS Waiver (Trade-Related Aspects of Intellectual Property Rights).

If the waiver is triggered, it would ostensibly nullify IP protections on COVID vaccines, allowing other countries to copy the formulas developed by private vaccine firms to inoculate their populations and play into the hands of future governments more hostile to private innovation.

This week, U.S. Trade Representative Katherine Tai met with the heads of the various vaccine makers to discuss the proposal, but it is uncertain if the Biden administration will support the measure at the WTO.

While many companies have voluntarily pledged to sell them at cost or even offered to share information with other firms, this measure would have more far-reaching implications.

This coalition seeking the TRIPS waiver includes Doctors Without Borders, Human Rights Watch, and World Health Organization Secretary-General Tedros Adhanom Ghebreyesus, who first backed this effort in 2020 before any coronavirus vaccine was approved.

They claim that because COVID represents such a global threat and because western governments have poured billions in securing and helping produce vaccines, low and middle-income countries should be relieved of the burden of purchasing them.

Considering the specialized knowledge needed to develop these vaccines and the cold storage infrastructure required to distribute them, it seems implausible that any of this could be achieved outside the traditional procurement contracts we’ve seen in the European Union and the U.S.

That said, rather than celebrating the momentous innovation that has led to nearly a dozen globally-approved vaccines to fight a deadly pandemic in record time, these groups are trumpeting a populist message that pits so-called “rich” countries against poor ones.

Intellectual property rights are protections that help foster innovation and provide legal certainty to innovators so that they can profit from and fund their efforts. A weakening of IP rules would actively hurt the most vulnerable who depend on innovative medicines and vaccines.

If the cost of researching and producing a COVID vaccine is truly $1 billion as is claimed, with no guarantee of success, there are relatively few biotechnology or pharmaceutical companies that can stomach that cost.

BioNTech, the German company headed by the husband-wife team of Uğur Şahin and Özlem Türeci that partnered with Pfizer for trials and distribution of their mRNA vaccine, was originally founded to use mRNA to cure cancer.

Before the pandemic, they took on massive debt and scrambled to fund their research. Once the pandemic began, they pivoted their operations and produced one of the first mRNA COVID vaccines, which hundreds of millions of people have received.

With billions in sales to governments and millions in direct private investment, we can expect the now-flourishing BioNTech to be at the forefront of mRNA cancer research, which could give us a cure. The same is true of the many orphan and rare diseases that do not otherwise receive major funding.

Would this have been possible without intellectual property protections?

Moderna, for its part, has stated it will not enforce the IP rights on its mRNA vaccine and will hand over any research to those who can scale up production. The developers of the Oxford-AstraZeneca vaccine have pledged to sell it at cost until the pandemic is over.

While this should smash the narrative presented by the populists and international organizations who wish to obliterate IP rights, instead they have doubled down, stating that these companies should hand over all research and development to countries that need them.

If we want to be able to confront and end this pandemic, we will continue to need innovation from both the vaccine makers and producers who make this possible. Granting a one-time waiver will create a precedent of nullifying IP rights for a host of other medicines, which would greatly endanger future innovation and millions of potential patients.

Especially in the face of morphing COVID variants, we need all incentives on the table to protect us against the next phase of the virus. 

Rather than seeking to tear them down those who have performed the miracle of quick, cheap, and effective vaccines, we should continue supporting their innovations by defending their intellectual property rights.

Yaël Ossowski (@YaelOss) is deputy director of the Consumer Choice Center, a global consumer advocacy group.

The Commission’s great U-Turn on mRNA vaccines

Here’s a change of heart we can support…

Back in January I published a blog post on this site asking the question of whether the new generation of COVID-19 vaccines will change our view on genetic engineering. In a statement back in July last year, the European Parliament said that “The derogation will facilitate the development, authorisation and consequently availability of COVID-19 vaccines and treatments”. According to EU legislation dating back to the early 2000s, genetic engineering is generally forbidden, with only a few exceptions. This was particularly driven by the scepticism of genetic engineering in agriculture. The Pfizer/Biontech, which to date remains the most prominent and incidentally most trusted COVID-19, something that surveys have also shown with our friends in the United States.

Now, the Commission is surfing the wave of the popularity of this vaccine in order to bank on mRNA shots for fighting COVID-19. And, as Euractiv reports, more voices are supportive of these vaccines in the fight against future pandemics: “Commenting on the news, centre-right MEP Peter Liese said he supported the decision to move towards mRNA vaccines, pointing out that they can be better adapted to mutations.”

Peter Liese is to be commended for his statement on this matter. Indeed, this new technology which relies on genetic engineering is very promising. For some experts, mRNA vaccines hold the key to faster and more effective vaccine programmes, capable of fighting multiple viruses in a single injection or providing protection against recalcitrant diseases (diseases characterised by poor survival and with little progress made in developing novel treatments).

In January, Moderna launched new programmes to develop mRNA vaccines for Nipah virus, HIV and influenza, adding to its portfolio of 20 mRNA candidates. Pfizer is also developing new mRNA vaccines, including one for seasonal flu. Several dozen other manufacturers and laboratories around the world are currently involved in similar initiatives.

The use of mRNA as a therapeutic or vaccine technique has been studied and developed for over a decade. Its interest seems to go beyond the field of vaccines against infectious diseases and also concerns cancers (see, for example, the immunotherapy products under development at BioNTech, or diseases with an autoimmune component (a treatment against multiple sclerosis is under development at BioNTech).

COVID-19 will have accelerated the large-scale evaluation of mRNA technologies. It is likely that this approach will expand massively in the coming years, also benefiting from advances in microencapsulation (nanoparticle) technologies. This technology could be refined by allowing nanoparticles to target specific cells by adding specific recognition molecules (e.g. ligands, receptors, antibodies) to the particle membrane. It will then be possible to deliver mRNA only to cells that need it (e.g. to compensate for the absence of a protein in genetic diseases, as with gene therapy, or to eliminate infected or tumour cells).

However, for this to happen the European Union ought to change its general approach to genetic engineering. While the support for the Pfizer/Biontech vaccine is commendable, more needs to be done from the point of view of legislation. There is a significant logical discrepancy when we are ready to use genetic engineering for medical purposes, but we somehow reject it in the field of agriculture. There are comparable health benefits to using similar technologies in our food; not least since the invention of vitamin B-heavy Golden Rice for the Asian market have genetically modified foods shown to be inherently linked to healthier food. On top of that, we can achieve our climate ambitions through new technologies that consume less resources at higher yields.

Originally published here.

Germany’s Vaccine Drive Problems

Fred Roeder went on TalkRadio’s Mark Dolan Show to discuss the shortcomings of the German Government around the COVID19 vaccine procurement.

Originally published here.

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