Werd I/O

[Annie Waldman at ProPublica]

UnitedHealth Group has been using an algorithm to determine whether patients have been receiving "too much" therapy and then cutting them off:

"Around 2016, government officials began to pry open United’s black box. They found that the nation’s largest health insurance conglomerate had been using algorithms to identify providers it determined were giving too much therapy and patients it believed were receiving too much; then, the company scrutinized their cases and cut off reimbursements."

The kicker here is the regulatory arbitrage: the practice has been ruled illegal in three states so far, but United simply undertakes its activities to a state where it's still legal. And because it doesn't answer to a single regulator, it's hard to impose stronger rules. In fact, more than 50 regulators each have jurisdiction over small slices of United's activities.

Effectively that makes it ungovernable:

"For United’s practices to be curbed, mental health advocates told ProPublica, every single jurisdiction in which it operates would have to successfully bring a case against it."

And:

"State regulators are supposed to be making sure private insurers that manage Medicaid plans are following the mental health parity laws. But this year, a federal audit found that they were failing to do so. “They are not well designed to essentially be watchdogs,” Lloyd said. “There’s very little accountability. Insurers can run roughshod over them.”"

In other words, the system needs to be radically overhauled if patients are going to receive adequate care. Will it be? Perhaps not soon.

#Health

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[Ian Sample in The Guardian]

"England’s former chief medical officer, Dame Sally Davies, has said there is no safe level of alcohol intake. A major study published in 2018 supported the view. It found that alcohol led to 2.8 million deaths in 2016 and was the leading risk factor for premature death and disability in 15- to 49-year-olds. Among the over 50s, about 27% of global cancer deaths in women and 19% in men were linked to their drinking habits."

This is important: older studies which suggested that there are some health benefits from light drinking are wrong, and the harms of alcohol have been understated. It's bad for you, end of story, and the alcohol industry has used similar techniques and arguments to the tobacco industry in order to cover that fact.

And the outcomes may be really bad:

"Last year, a major study of more than half a million Chinese men linked alcohol to more than 60 diseases, including liver cirrhosis, stroke, several gastrointestinal cancers, gout, cataracts and gastric ulcers."

It's disappointing news for people like me who enjoy a drink from time to time - but it's better to know than not. There's a real trade-off to those glasses of wine.

#Health

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[Chris Bing and Joel Schechtman at Reuters]

"The U.S. military launched a clandestine program amid the COVID crisis to discredit China’s Sinovac inoculation – payback for Beijing’s efforts to blame Washington for the pandemic. One target: the Filipino public. Health experts say the gambit was indefensible and put innocent lives at risk."

Reading this, it certainly seems indefensible, although unfortunately not out of line with other US foreign policy efforts. Innocent people died because of this US military operation.

It's a reflection of the simple idea, which seems to have governed US foreign policy for almost a century, that foreign lives matter less in the quest for dominance over our perceived rivals.

Even if you do care about America more than anywhere else, this will have hurt at home, too. The internet being what it is, it also would make sense that these influence campaigns made their way back to the US and affected vaccine uptake on domestic soil.

The whole thing feels like the military equivalent of a feature built by a novice product manager: someone had a goal that they needed to hit, and this was how they decided to get there. But don't get me wrong: I don't think this was an anomaly or someone running amok. This was policy.

#Health

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"Your individual risk depends on a large number of factors, but there's a consensus: one out of every ten people who catch Covid go on to develop Long Covid. It's not a one-time risk, either. You face these odds every single time you catch the disease." And that's just the start of it.

Telomere attrition is a side effect that caught my eye, given the telomere dysfunction that runs in my family. The virus ages you - including by compromising your immune system - but it's even worse if you're already immunocompromised or prone to premature ageing.

This piece goes further into the side effects and issues with covid. It's something we need to continue to fight; it's a pandemic that's far from over. Glossing it over in the name of proximal economic stability is short-sighted. People are dying, and even when they're not, the effects can last a lifetime. #Health

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Big news for people who can get pregnant and the people who care about them (which should be everyone):

"New research published by the journal Nature points to the discovery that a single hormone causes nausea and vomiting in pregnancy: GDF15. Researchers found that the amount of this hormone in a pregnant person’s bloodstream before and during pregnancy determines the severity of the nausea and vomiting. GDF15 is released by the body in response to stress, with the receptors of this hormone rooted in the part of the brain responsible for triggering vomiting."

Trials are already underway - with really good hope for effective treatment and prevention. #Health

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"The United States has long lagged when it comes to pregnancy-related health. There is a unique danger to pregnancy for Black Americans, who face higher mortality and morbidity rates because of entrenched, systemic racism."

An important series of articles examining what pregnancy looks like in modern-day America - particularly in places where reproductive health rights have been removed, and where outcomes and care are not what they should be.

The American healthcare system is fucked, and it's worse for women, people of color, and LGBT Americans. It's important to throw a spotlight onto the lived experiences of the people who experience the brunt of this. #Health

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I sometimes wonder what is being concealed from us today that we'll find out has been killing us decades later? Are these sorts of efforts underway for cellphones or food supplements or some other ubiquitous good? 

I mean, probably. We'll have to wait and see what. In the meantime, I'm looking at induction stovetops. #Health

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Depressing. I agree that vaccine denial is not going away, and that we need to find other ways to mitigate outbreaks. But what a sad situation to be in. #Health

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Taking lean startup research techniques that were developed for basic social networks or, say, 3D avatars and transposing them to real-world domains with real consequences seems to be an ongoing trend. It's a misunderstanding of the startup playbook that causes real harm. This is obviously unethical; it is nowhere near as "nuanced" as this CEO says it is. #Health

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Utterly heartbreaking. #Health

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It's not really mentioned in this article, but lead sheathing isn't just used in old phone cabling. It's in some modern cabling too, including underground and undersea cables used to provide internet. And the health risks are real. #Health

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“The 19th spoke with health care professionals who provide gender-affirming care to adults and adolescents — as well as trans young adults who were comfortable sharing their experiences — to answer those questions.” #Health

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“100% of trans people who seek access to gender affirming care as children and are denied go through the horror. 100% of trans children who never know that gender affirming care exists go through the horror. And for what?” #Health

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A characteristically nuanced, in-depth piece about the debate around assisted suicide. #Health

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An actual nightmare. #Health

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“A groundbreaking epidemiological study has produced the most compelling evidence yet that exposure to the chemical solvent trichloroethylene (TCE)—common in soil and groundwater—increases the risk of developing Parkinson’s disease.” By as much as 70%! #Health

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“Maternity leave should still be our top policy priority in the U.S. However, paternity leave is an important next step. In the shorter term, for individuals and companies, these results are worth considering. Flexibility for overlapping leave in the short term, and concentrated father time in the first year, both appear to have positive impacts.” #Health

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“The problem with loneliness seems to be that it biases our thinking. In behavioral studies, lonely people picked up on negative social signals, such as images of rejection, within 120 milliseconds — twice as quickly as people with satisfying relationships and in less than half the time it takes to blink. Lonely people also preferred to stand farther away from strangers, trusted others less and disliked physical touch.” #Health

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“The full analysis provides additional compelling evidence that the pandemic coronavirus made its leap to humans through a natural spillover, with a wild animal at the market acting as an intermediate host between the virus's natural reservoir in horseshoe bats and humans.” #Health

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"According to data from the United Network for Organ Transplants (UNOS), in the U.S., about one in 10 lung transplants now go to COVID-19 patients. [...] COVID seems to cause very severe pneumonia in some patients, leading to acute respiratory distress syndrome (ARDS) and even leading to pulmonary fibrosis in some patients.” #Health

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“People living in the same household share more than just a roof. Be they family or flatmate, housemates tend to have the same microbes colonizing their bodies, and the longer the cohabitation, the more similar these microbiomes become. The conclusion raises the possibility that diseases linked to microbiome dysfunction, including cancer, diabetes and obesity, could be partly transmissible.” #Health

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“Alarmingly, in a focus group conducted by the Public Health Law Center in Chicago, nearly 100 percent of public housing participants said they have also turned on their gas stoves to stay warm on cold days, which is an added danger for residents.” #Health

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“The proportion of childhood asthma that could be theoretically prevented if gas stove use was not present (e.g., state-specific PAFs) varied by state (Illinois = 21.1%; California = 20.1%; New York = 18.8%; Massachusetts = 15.4%; Pennsylvania = 13.5%). Our results quantify the US public health burden attributed to gas stove use and childhood asthma.” #Health

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“The chocolate industry has been grappling with ways to lower those levels. To see how much of a risk these favorite treats pose, Consumer Reports scientists recently measured the amount of heavy metals in 28 dark chocolate bars. They detected cadmium and lead in all of them.” #Health

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“In fact, reducing the temperature inside the nose by as little as 9 degrees Fahrenheit (5 degrees Celsius) kills nearly 50% of the billions of virus and bacteria-fighting cells in the nostrils.” Aside from blocking droplets, masks make you healthier because they’re like “a sweater for your nose”. #Health

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