FHI's Week in Review - 5/6/19 - Hooked on Big Tobacco + Medicare Reforms Follow a Competition & Choice Driven Vision

Volume VI, Issue 18

May 6, 2019

How Big Tobacco Got a New Generation Hooked

Alex Bogusky ran an effective marketing campaign 20 years ago that helped "young people to see the tobacco companies as they really were" when it came to marketing cigarettes. His NY Times editorial, published 5/3/19, points out the current regulatory hole that is allowing Big Tobacco to ramp up marketing for vaping to teenagers. These marketing efforts have the potential to wipe out the significant public health progress over the past 2 decades in reducing tobacco use in teenagers. He advocates for corporate moral responsibility in the advertising industry through the "Quit Big Tobacco" campaign.

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"Few healthcare professionals and executives who read this editorial will support Big Tobacco marketing vaping to teenagers," according to Craig Tanio, MD, MBA, a member of the executive team at Rezilir Health in Hollywood, FL. "It has been 55 years since the Surgeon General's first report on cigarettes and the facts are clear. However, in many other healthcare issues that we face - opioids and pain, medical marijuana, green algae & other environmental toxins - the truth is not necessarily as clear nor widely communicated."

As an example, Dr. Tanio points to this link from the CDC on the top environmental toxicants that pose the most significant threat to human health - how many of these does your health care system test for?

"Our professional duty as healthcare leaders is to understand the real facts and to draw the right line on individual and corporate responsibility," concludes Dr. Tanio. "Alex gives a good example how."

How The Trump Administration Is Reforming Medicare

A May 3 post on Health Affairs, authored by J ohn C. Goodman and Lawrence J. Wedekind, details how the Trump administration is making fundamental changes to the Medicare program. It seems likely that the changes initiated so far are only the beginning of a continuing shift in the role of government in health care, according to the authors. The authors examine quality, information and cost incentives and compare MA's to ACO's. The vision behind these reforms can be found in the Department of Health and Human Services' Reforming America's Healthcare System Through Choice and Competition.

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The Trump administration is clearly pushing the envelope, in many cases acting to fill a void left by Congress, the authors conclude. These changes will result in a very different healthcare system. It will be one that is shaped more by individual choice and market forces than by rules and regulations.

FDA adds Boxed Warning for risk of serious injuries caused by sleepwalking with certain prescription insomnia medicines

FDA.gov posted this release on Apr. 30:

The Food and Drug Administration (FDA) is advising that rare but serious injuries have happened with certain common prescription insomnia medicines because of sleep behaviors, including sleepwalking, sleep driving, and engaging in other activities while not fully awake. These complex sleep behaviors have also resulted in deaths. These behaviors appear to be more common with eszopiclone ( Lunesta), zaleplon (Sonata), and zolpidem (Ambien, Ambien CR, Edluar, Intermezzo, Zolpimist) than other prescription medicines used for sleep. As a result, we are requiring a Boxed Warning, our most prominent warning, to be added to the prescribing information and the patient Medication Guides for these medicines.

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This is an important reminder that pharmaceuticals can have powerful side effects. "I've had to send patients back home in an Uber because they slept-drove to my office after taking Ambien," states Sandra Doman, DC, founder of Miami Sports Chiropractic and Yoga Center in Aventura, FL. "There are natural therapies to improve sleep quality," she adds.