Americans broadly consent to funding clinical research because they believe in the promise of medical research. But people support scientific work only if they trust that it serves societal interests, respects patient dignity and operates with guardrails.Collection: Trust
Among the most common reasons why people come to an emergency room are bouts of heart failure or pneumonia. Sometimes they have a touch of both.Collection: Failure
President Obama famously promised that the Affordable Care Act would not only slow the growth in health care costs, but would also reverse these trends, making the average health insurance plan cheaper. That isn't happening.Collection: Health
The convergence of information technology and biology allows scientists to translate the human genome into digital data that can accelerate diagnoses and cures.Collection: Technology
It's important to protect the old and the vulnerable, who are at the highest risk of severe illness and bad outcomes. But like most issues of medicine, it isn't a binary choice. Given the uncertainties of how this virus spreads and its high risk of infirmities, it would be unwise to abandon efforts to limit Covid spread wherever possible.
Gene therapies and other treatments that can cure - not just treat - disease are going to be expensive. All of the cost of innovating and reaping an economic return may need to be recouped in a single payment.
One thing about Covid-19 is clear: We don't fully understand its severity and transmission. At various turns, we've both underestimated and overestimated the virus.
When gene therapy was believed to harbor latent risks, research was largely put on hold until the risks were better understood. Sometimes, the theoretical risks have led to a principle of absolutist precaution that impedes progress.
What makes the EpiPen unique is its delivery vehicle - an auto-injector that's packaged in a convenient, pen-like device. The product's key attribute is its ability to reliably deliver accurate doses of the essential medicine.
Smallpox can be personally devastating. After a 14-day incubation period, patients experience high fevers, headaches, and sometimes severe abdominal pain. A rash resembling chicken pox appears in the mouth and throat, face, and forearms, and spreads to the trunk and legs. As patients recover, scabs break and pitted scars appear.
From West Nile to swine flu to Ebola to the global outbreak of dengue fever, the capacity to deal with threats like Zika must be designed into our preparedness posture.
Patients would be better off if states were able to tailor the benefits that Medicaid covers - targeting resources to sicker people and giving healthy adults cheaper, basic coverage.
Advocacy groups like Families U.S.A. imagine that once Medicaid becomes a middle-class entitlement, political pressure from middle-class workers will force politicians to address these problems by funneling more taxpayer dollars into this flawed program. President Barack Obama's health plan follows this logic.
One option is to run Medicaid like a health program - rather than an exercise in political morals - and let states tailor benefits to the individual needs of patients, even if that means abandoning the unworkable myth of 'comprehensive' coverage.
The fact is, many poor patients visit ERs simply because they don't have a family doctor.
A seductive technology that works like a dream and improves lives will set off a consumer clamor, whether the new tool is an iPhone 4S or an implantable blood-sugar meter.
Printing novel DNA might open the way to achievements once only conceivable in science fiction: designer bacteria that can produce new chemicals, such as more efficient fuels, or synthetic versions of our cells that make us resistant to the effects of radiation.
It once seemed that the most profound feats stemming from DNA-based science would spring from our ability to read and detect genes, which we call the science of genomics. But the real opportunities lie in our ability to write DNA, to synthesize new gene sequences and insert them into organisms, resulting in brand-new biological functions.
We've been scared from using antibiotics and antivirals out of some kind of weird sense of communal responsibility to keep bugs naive to our powerful weapons.
Regulators at the Food and Drug Administration have a tough job.
Policies I advanced as FDA commissioner aimed to get smokers off cigarettes and onto less-harmful forms of nicotine delivery.
There are two main types of immunity to an infection. Innate immunity comes from circulating cells that attack any invader the body views as foreign. Adaptive immunity is specific to the pathogen presented. Through adaptive response, immune cells are programmed to secrete antibodies that are primed to target a viral invader.
Health-assessment software such as CareEvolution's 'Safer Covid' tool can combine multiple health factors to evaluate a person's total risk of contracting Covid or suffering a bad outcome.
There's instinctual discomfort about using evidence of past immunity as a factor for decisions about health, work or even questions like whether it's safe to visit someone in a nursing home. But there are ways to deploy immunity information to help us understand our own health status and keep us safer from Covid, without surrendering privacy.
Covid-19 may be here for a long time.
The first nation to develop a vaccine for Covid-19 could have an economic advantage as well as a tremendous public-health achievement. Doses will be limited initially as suppliers ramp up, and a country will focus on inoculating most of its own population first.
Covid-19 has altered world history.
It's now evident that public health is part of national security.
At the heart of President Barack Obama's health-care plan is an insurance program funded by taxpayers, administered by Washington, and open to everyone. Modeled on Medicare, this 'public option' will soon become the single dominant health plan, which is its political purpose. It will restructure the practice of medicine in the process.
Rather than redistribute physician income as a way to subsidize an expansion of government control, Mr. Obama should fix the payment system to align incentives with improved care.
More government control of doctors and their reimbursement schemes will only create more problems.
When some states introduced mandatory smallpox vaccinations during the epidemic of 1898-1903, Americans resisted by the thousands. The ensuing battles produced medical conventions and case law that altered the balance between government authority and medical practice, in favor of federal control.
In 'Pox: An American History,' Michael Willrich meticulously traces the story of how the smallpox vaccine was pressed into service during a major outbreak.
Historical records show that smallpox was a human scourge for thousands of years. The virus produces high fever, severe back pain and scarring eruptions of flat red spots on the skin that turn into pustules and then into scabs - a two-week process during which the disease is highly contagious.
The authors of the Affordable Care Act wrongly assumed that new kinds of health plans, engineered in Washington, D.C., would emerge to displace the national for-profit insurers.
The truth is that the greatest innovations in health-care delivery haven't come from federally contrived oligopolies or enormous hospital chains. Novel concepts - whether practice-management companies, home health care or the first for-profit HMO - almost always have come from entrepreneurial firms, often backed by venture capital.
Why do physicians prescribe powerful antibiotics? Generally not because our patients ask for them. Most people who come in with a sore throat would be just as happy leaving my office with a prescription for Chloraseptic as clarithromycin.
Antibiotic resistance is as old as the dirt that coats our planet.
Covid spreads too easily to think it can be confined to the young.
Confronting a dangerous pandemic requires containing spread wherever it is reasonably possible. Sensible measures such as universal masking, testing and widespread and rapid contact tracing can help. The best way to protect the vulnerable is to try to protect everyone.
In countries such as France and Germany, layers of bureaucracy like health boards have been specifically engineered to delay the adoption of new medical products and services, thus lowering spending.
Our Founders thought politicians should be accountable when it comes to citizens' right to life, liberty and the pursuit of heart surgery.
One of the biggest factors fueling the angst over drug prices in the U.S. is that some older medicines that should be sold cheaply as generics are still priced very high, often owing to a dwindling number of generic competitors and the rising cost of producing these drugs.
When the price of a drug rises, it becomes profitable and the target of new competition.
The key to the generic-drug economic model is to keep entry prices low enough to attract multiple competitors.
Biologics must be grown in living systems - fermented, for example, in large vats of bacteria cells. This makes them hard to replicate. For decades, biologics weren't subject to competition from copycat generic medicines, even once patents and exclusivities had lapsed on originals.
Covid is likely to persist once its pandemic phase has passed and circulate each winter alongside the flu. Even after more of us contract coronavirus infection and develop immunity to it or even after an effective vaccine arrives, some people will still get very sick.
America tolerates a heavy toll from the flu on health and productivity. But if Covid becomes a twin risk, the heath-care system will struggle to fight both at once.
Limiting Covid's impact requires us to think differently about confronting respiratory pathogens in the winter.
A respiratory pathogen may pose an asymmetric risk to America, given our culture, economy and federalist system.