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Saturday, February 11, 2023

Nebraska considers medical conscientious objection bill

 Nebraska lawmakers are following the path of other conservative states in considering a bill that would allow medical providers, facilities and insurers to cite their religious, ethical or moral beliefs in denying some medical treatments. Critics say it’s simply another way to target abortion rights and the LGBTQ community.

The bill, introduced by Sen. Dave Murman, of Glenvil, casts a wide net. The term “medical providers” covers everyone from doctors, nurses and pharmacists to mental health counselors and nursing home staffers — all of whom could refuse to perform nonemergency procedures, from abortions and gender-affirming hormone treatments to prescribing birth control — if the provider has a moral objection to it.

The bill includes nearly three pages of language protecting providers who conscientiously object to providing treatment from lawsuits, criminal charges and professional ethics charges.

The bill would also allow medical practices, clinics and hospitals to refuse treatment based on conscientious objections and would allow businesses and health insurance companies to refuse to pay for treatment for the same reasons.

Murman said the measure does not give carte blanche to those providers and entities to discriminate against patients. A doctor who identifies as a Christian could not, for example, refuse to treat someone because the person is Muslim, or vice versa.

“The act is procedure specific, not patient specific,” Murman said Friday at a hearing for the bill before the Legislature’s Health and Human Services Committee.

A similar bill is being considered in Montana, and in 2021, Arkansas passed its own medical conscientious objection law. In Idaho, a bill widely seen as targeting LGBTQ residents would allow mental health therapists and counselors to refuse to treat clients if the clients’ goals or behaviors conflict with the counselor’s “sincerely held principles” narrowly advanced from a legislative committee Thursday.

Jane Seu, legal and policy counsel with the American Civil Liberties Union, was among those who opposed the Nebraska bill Friday, saying it would “provide an unbridled license to health care professionals to discriminate against their patients for almost any reason.”

“This license to discriminate will be felt more severely in rural areas where patients have a limited choice of medical providers,” she said.

Eliana Siebe-Walles, a 20-year-old student at the University of Nebraska-Lincoln who uses the pronoun they, told the committee that they suffer from a reproductive condition that is treated with birth control hormones.

“Under this bill, a provider could potentially keep me from getting the treatment I need,” they said.

Outside the hearing, Siebe-Walles said their main concern is that this bill could be used by medical staff to discriminate, “especially against people of color and queer people who are already more burdened than others when it comes to getting the care they need.”

That fear is prevalent, too, in Idaho, where a bill prohibiting all gender-affirming medical care is expected to pass the Idaho House. That, coupled with the conscientious objection bill for mental health workers, has some LGBTQ residents and allies worried that young people there will soon be facing a near-total healthcare hurdle.

Kris Huntting, a transgender parent raising a transgender teen in southwestern Idaho, was refused treatment by their own long-time therapist several years ago after revealing they were trans. Now Huntting is worried about their son’s healthcare access, even though the 15-year-old has not yet expressed an interest in gender-affirming medical care.

“One thing I’ve really struggled with is that his doctor knows he’s trans,” Huntting said Thursday. “Should that have been a thing I mentioned medically to his doctor, or is he not going to be treated for his depression and anxiety anymore — which he’s had all his life — because it will be considered related to his gender dysphoria diagnosis, or because a therapist might not like that?”

The American Medical Association’s code of medical ethics says physicians have an ethical obligation to provide care in medical emergencies and that doctors “must also uphold ethical responsibilities not to discriminate against a prospective patient on the basis of race, gender, sexual orientation, or gender identity, or other personal or social characteristics that are not clinically relevant to the individual’s care.”

Keeping that in mind, doctors may decline to provide treatment “in certain limited circumstances,” which include if the patient requests care that is “incompatible with the physician’s deeply held personal, religious or moral beliefs,’’ according to the code.

https://apnews.com/article/abortion-access-to-health-care-costs-nebraska-nursing-homes-eb1a6283b8127610ccb8d279ce218fa5

Ice baths benefits may be lukewarm

 The coolest thing on social media these days may be celebrities and regular folks plunging into frigid water or taking ice baths.

The touted benefits include improved mood, more energy, weight loss and reduced inflammation, but the science supporting some of those claims is lukewarm.

Kim Kardashian posted her foray on Instagram. Harry Styles has tweeted about his dips. Kristen Bell says her plunges are “brutal” but mentally uplifting. And Lizzo claims ice plunges reduce inflammation and make her body feel better.

Here’s what medical evidence, experts and fans say about the practice, which dates back centuries.

THE MIND

You might call Dan O’Conor an amateur authority on cold water immersion. Since June 2020, the 55-year-old Chicago man has plunged into Lake Michigan almost daily, including on frigid winter mornings when he has to shovel through the ice.

“The endorphin rush … is an incredible way to wake up and just kind of shock the body and get the engine going,” O’Conor said on a recent morning when the air temperature was a frosty 23 degrees (minus-5 Celsius). Endorphins are “feel good” hormones released in response to pain, stress, exercise and other activities.

With the lake temperature 34 degrees (1 Celsius), the bare-chested O’Conor did a running jump from the snow-covered shore to launch a forward flip into the icy gray water.

His first plunge came early in the pandemic, when he went on a bourbon bender and his annoyed wife told him to “go jump in the lake.” The water felt good that June day. The world was in a coronavirus funk, O’Conor says, and that made him want to continue. As the water grew colder with the seasons, the psychological effect was even greater, he said.

“My mental health is a lot stronger, a lot brighter. I found some Zen down here coming down and jumping into the lake and shocking that body,” O’Conor said.

Dr. Will Cronenwett, chief of psychiatry at Northwestern University’s Feinberg medical school, tried cold-water immersion once, years ago while visiting Scandinavian friends on a Baltic island. After a sauna, he jumped into the ice-cold water for a few minutes and had what he called an intense and invigorating experience.

“It felt like I was being stabbed with hundreds of millions of really small electrical needles,” he said. “I felt like I was strong and powerful and could do anything.”

But Cronenwett says studying cold water immersion with a gold-standard randomized controlled trial is challenging because devising a placebo for cold plunges could be difficult.

There are a few theories on how it affects the psyche.

Cronenwett says cold water immersion stimulates the part of the nervous system that controls the resting or relaxation state. That may enhance feelings of well-being.

It also stimulates the part of the nervous system that regulates fight-or-flight stress response. Doing it on a regular basis may dampen that response, which could in turn help people feel better able to handle other stresses in their lives, although that is not proven, he said.

“You have to conquer your own trepidation. You have to muster the courage to do it,” he said. “And when you finally do it, you feel like you’ve accomplished something meaningful. You’ve achieved a goal.”

Czech researchers found that cold water plunging can increase blood concentrations of dopamine — another so-called happy hormone made in the brain — by 250%. High amounts have been linked with paranoia and aggression, noted physiologist James Mercer, a professor emeritus at the Arctic University of Norway who co-authored a recent scientific review of cold water immersion studies.

THE HEART

Cold water immersion raises blood pressure and increases stress on the heart. Studies have shown this is safe for healthy people and the effects are only temporary.

But it can be dangerous for people with heart trouble, sometimes leading to life-threatening irregular heartbeats, Cronenwett said. People with heart conditions or a family history of early heart disease should consult a physician before plunging, he said.

METABOLISM

Repeated cold-water immersions during winter months have been shown to improve how the body responds to insulin, a hormone that controls blood sugar levels, Mercer noted. This might help reduce risks for diabetes or keep the disease under better control in people already affected, although more studies are needed to prove that.

Cold water immersion also activates brown fat — tissue that helps keep the body warm and helps it control blood sugar and insulin levels. It also helps the body burn calories, which has prompted research into whether cold water immersion is an effective way to lose weight. The evidence so far is inconclusive.

IMMUNE SYSTEM

Anecdotal research suggests that people who routinely swim in chilly water get fewer colds, and there’s evidence that it can increase levels of certain white blood cells and other infection-fighting substances. Whether an occasional dunk in ice water can produce the same effect is unclear.

Among the biggest unanswered questions: How cold does water have to be to achieve any health benefits? And will a quick dunk have the same effect as a long swim?

“There is no answer to ‘the colder the better,’” Mercer said. “Also, it depends on the type of response you are looking at. For example, some occur very quickly, like changes in blood pressure. ... Others, such as the formation of brown fat, take much longer.”

O’Conor plunges year-round, but he says winter dunks are the best for “mental clarity,” even if they sometimes last only 30 seconds.

On those icy mornings, he is “blocking everything else out and knowing that I got to get in the water, and then more importantly, get out of the water.”


The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

https://apnews.com/article/health-8d7e4523e0587837ce9ec8c1befce649

Fetterman "Laboring" To Adjust To Senate Due To "Special Needs"

 Now that the election is long gone and Senator John Fetterman has had another stint in the hospital, the New York Times is finally telling us what we all knew months ago: Fetterman isn't fit for the job.

But the Times still has some trouble admitting the obvious truth, writing in a piece this week that Fetterman was "laboring" to adjust to the role. 

And despite many on the left freaking out last week about the use of "special needs" when describing Fetterman, here's how the Times led a new piece on the Senator:

At Senator John Fetterman’s desk in the Senate chamber, there is a newly installed monitor that rises or lowers, depending on whether he sits or stands, and provides closed captioning so he can follow the proceedings. At the center dais, a custom desk stand has been built to accommodate the same technology for when he takes his shifts presiding over the Senate.

The Times seems eager to walk back any previous endorsements of Fetterman...now that his vote in the Senate is secure. He was "never going to blend in seamlessly in the marbled corridors of Congress," the new piece writes.

It also laments Fetterman's "physical impairment and serious mental health challenges that have rendered the transition extraordinarily challenging - even with the accommodations that have been made to help him adapt."

The coup de grĂ¢ce was delivered when the Times wrote that Fetterman's most evident disability is a "neurological condition that impairs his hearing", stating that he also had a pacemaker and defibrillator implanted inside of him after his stroke. 

Fetterman's staff admits he "needs a better plan to take care of himself, both physically and emotionally," the report - which he declined to be interviewed for - says. 

Photo: NY Times

The Times report also highlighted Fetterman's need for additional resources while in Washington DC. The Times wrote that he "typically walks around the building with many staffers, in part because he needs assistants to test his technological setup before he enters any room and in part because they’re all still learning their way around the building."

And while the Times has obviously come to terms with Fetterman's inability to do his job, other Democrats like Amy Klobuchar aren't yet ready to admit Fetterman's obvious shortcomings. Klobuchar, in true "woke" guilt fashion, instead blames herself: “He answers like you would answer anyone. It’s us that have to get used to it; he’s used to it."

Klobuchar's delusional reality aside, it is now clear that Fetterman may not be able to finish his term. And the media was complicit in allowing it, despite the fact that Fetterman refused to release his medical records prior to Election Day.

As Zero Hedge contributor Quoth the Raven wrote back in October: "Without releasing his full medical records, everyone is simply left to wonder whether or not Fetterman is just communicatively “disabled” or whether he is truly cognitively impaired."

Now, we have our answer.

"The true travesty of the situation isn’t just that Mr. Fetterman is being told by those around him to forge forward... but that those supporting him could have a clear conscience after having the nerve to turn the issue into one of discrimination when everyday people ask honest questions about Fetterman’s condition," QTR continued back in October. 

"To some degree, it’s par for the course for the left, who has seemingly made everything about identity politics over the last decade. I almost can’t even blame the base for that; it’s ingrained in them. But what I can take exception with is the fact that no one had the same nerve to step in and level with Fetterman or his family that he obviously may not be the best candidate for the job."

Now the question becomes: who will step in to his Senate seat when he inevitably has to step down? 

Say hello to Senator Gisele...

 https://www.zerohedge.com/markets/extraordinarily-challenging-new-york-times-says-john-fetterman-laboring-adjust-role-senate

Top 100 hospitals for joint replacements by state, per Healthgrades

 Healthgrades has recognized 100 hospitals with their Joint Replacement Excellence Award. These hospitals earned this award due to their superior clinical outcomes in knee and hip replacement.

Healthgrades evaluated the award based on hip replacement and total knee replacement procedures and in-hospital complications. For more details about their methodology, see here.

Read on for Healthgrades’ 2023 list of top hospitals for joint replacement by state:

Alabama

Jack Highston Memorial Hospital (Phenix City)

 

Arizona

Abrazo Scottsdale Campus (Phoenix)

Arizona Spine And Joint Hospital (Mesa)

The Core Institute Specialty Hospital (Phoenix) 



Arkansas

Arkansas Surgical Hospital (North Little Rock)

California

Eisenhower Medical Center (Rancho Mirage)

Goleta Valley Cottage Hospital (Santa Barbara)

Kaiser Permanente Orange County - Anaheim Medical Center

Kaiser Permanente San Leandro Medical Center

Los Robles Regional Medical Center (Thousand Oaks)

Palomar Medical Center Escondido 

Providence Saint John's Health Center (Santa Monica)

Redlands Community Hospital 

Scripps Green Hospital (La Jolla)



Colorado

Poudre Valley Hospital (Fort Collins)

Connecticut

Saint Francis Hospital (Hartford)

 

Delaware

Christiana Hospital (Newark)



Florida 

Bethesda Hospital East (Boynton Beach)

Coral Gables Hospital

HCA Florida Blake Hospital (Bradenton)

HCA Florida Capital Hospital (Tallahassee)

HCA Florida JFK Hospital (Atlantis)

HCA Florida North Florida Hospital (Gainesville)

HCA Florida Oak Hill Hospital (Brooksville)

HCA Florida Ocala Hospital 

HCA Florida St. Lucie Hospital

UF Health Shands Hospital (Gainesville)

 

Georgia

Northside Hospital Forsyth (Cumming)

Idaho

St. Luke's Boise Medical Center

 

Illinois

Northwestern Medicine McHenry Hospital 

 

Indiana

Franciscan Health Lafayette East 

Lutheran Health Network - The Orthopedic Hospital (Fort Wayne)

OrthoIndy Hospital (Indianapolis)

Parkview Ortho Hospital (Fort Wayne)



Kansas

Kansas City Orthopaedic Institute (Leawood)

Kansas Spine and Specialty Hospital (Wichita)

Kansas Surgery and Recovery Center (Wichita)

Menorah Medical Center (Overland Park)

Mercy Specialty Hospital Southeast Kansas  (Galena)

Salina Surgical Hospital 

Stormont Vail Hospital (Topeka)

 

Maine

Maine Medical Center (Portland)



Maryland

Anne Arundel Medical Center (Annapolis)

Mercy Medical Center (Baltimore)

University of Maryland St. Joseph Medical Center (Towson)



Michigan

Ascension Borgess Hospital (Kalamazoo)

Bronson Methodist Hospital (Kalamazoo)

Holland Hospital

Munson Medical Center (Traverse City)

 

Minnesota

Abbott Northwestern Hospital (Minneapolis)

Mercy Hospital (Coon Rapids)

United Hospital (Saint Paul)

 

Missouri

Boone Hospital Center (Columbia)

Mercy Hospital Springfield

 

Nebraska

Midwest Surgical Hospital (Omaha)

OrthoNebraska Hospital (Omaha)

 

New Mexico

Presbyterian Hospital (Albuquerque)

 

North Carolina

Atrium Health Carolinas Medical Center (Charlotte)

Davie Medical Center (Bermuda Run)

Mission Hospital (Asheville)

Novant Health Forsyth Medical Center (Winston-Salem)

 

Ohio

Crystal Clinic Orthopaedic Center (Akron)

Kettering Health Main Campus

Mount Carmel New Albany Surgical Hospital (New Albany)

 

Oklahoma

Center for Orthopaedic Reconstruction & Excellence (Jenks)

Mcbride Orthopedic Hospital (Oklahoma City)

Oklahoma Surgical Hospital (Tulsa)

 

Pennsylvania

Advanced Surgical Hospital (Washington)

Doylestown Hospital

OSS Orthopaedic Hospital (York)

Reading Hospital

Rothman Orthopaedic Specialty Hospital (Bensalem)

St. Mary Medical Center (Langhorne)

Surgical Institute of Reading (Wyomissing)

UPMC St. Margaret (Pittsburgh)

South Carolina

Hilton Head Regional Medical Center

Prisma Health Baptist Hospital (Columbia)

Prisma Health Patewood Hospital (Greenville)

St. Francis Downtown (Greenville)

 

South Dakota

Black Hills Surgical Hospital (Rapid City)

Sioux Falls Specialty Hospital

 

Tennessee

Tristar Centennial Medical Center (Nashville)

 

Texas

Baylor Scott & White Orthopedic and Spine Hospital - Arlington

Baylor Scott and White Texas Spine and Joint Hospital (Tyler)

Corpus Christi Medical Center - Bay Area

Guadalupe Regional Medical Center (Seguin)

Quail Creek Surgical Hospital (Amarillo)

South Texas Spine And Surgical Hospital (San Antonio)

St. David's Medical Center (Austin)

Texas Orthopedic Hospital (Houston)

 

Utah

LDS Hospital (Salt Lake City)

McKay Dee Hospital (Ogden)

The Orthopedic Specialty Hospital (Murray)

Virginia

Chippenham Hospital (Richmond)

Henrico Doctors' Hospital (Richmond)

Reston Hospital Center (Reston)

 

West Virginia

Cabell Huntington Hospital

Wisconsin

Orthopaedic Hospital Of Wisconsin (Glendale)

Sauk Prairie Hospital (Prairie du Sac)

Vernon Memorial Hospital (Viroqua)


https://www.beckershospitalreview.com/rankings-and-ratings/top-100-hospitals-for-joint-replacements-by-state-per-healthgrades.html

Texas hospital official banned from LinkedIn after COVID-19 posts

 The elected board member of a Texas hospital has been banned from his LinkedIn account after sharing multiple posts relating to COVID-19, The Texan reported Feb. 10. 

Wallace Dunn serves Medical Center Hospital, a 402-bed regional hospital in Odessa, Texas, and frequently uses his account to represent the hospital. 

Two of Mr. Dunn's posts about the efficacy of the COVID-19 vaccine were deemed "misleading or inaccurate" by the platform, leading to bans of four and six weeks. He was banned for another post regarding early home-based treatment options for the virus, which linked back to a publication from the American Association of Physicians and Surgeons. Now, he is locked out of his account permanently, but does not know which post triggered the ban and says the platform will not tell him. 

"I have many constituents who follow me [on LinkedIn] and this ban hinders my ability to communicate with them," Mr. Dunn told the newspaper.

The bans have rebooted conversations surrounding HB20, a Texas law prohibiting social media platforms from censoring users' posts. The law is currently on hold while it is reviewed by the U.S. 5th Circuit Court of Appeals. 

https://www.beckershospitalreview.com/hospital-management-administration/texas-hospital-official-banned-from-linkedin-after-covid-19-posts.html

Shot-down Chinese balloon may affect US medical supply chain

 After the U.S. shot down a "high-altitude object" hovering above Alaska's waters on Feb. 10 and a confirmed Chinese spy balloon the week prior, it's unclear what these actions mean for the U.S.-China medical supply chain. 

Some domestic medical supply companies are already leaning away from healthcare products made in China, but 32 percent of the world's supply of antibiotics is made in China, according to the US-China Business Council. For the location of facilities that manufacture active pharmaceutical ingredients used in the U.S., 28 percent are in the U.S., 26 percent in the European Union, 18 percent in India, 13 percent in China, 2 percent in Canada and 13 percent elsewhere, according to 2019 data from the FDA

"The Chinese balloon incident is the canary in the coal mine for the U.S. healthcare industry," Tinglong Dai, PhD, a professor of operations management and business analytics at Johns Hopkins University in Baltimore, told Becker's. "Our hyper-globalized supply chains leave us vulnerable to any geopolitical hiccup. It's time for healthcare executives to take a hard look at their supply chains and invest in reshoring, nearshoring and friendshoring to build a more diversified and secure system. A resilient supply chain is the cornerstone of a strong healthcare system, and neglecting it is like leaving the foundation of a building unsecured — it may seem stable for a while, but a surprise disruption could bring the whole structure crashing down. Let's not wait for the next surprise to take action."

In a Feb. 7 opinion for The Hill, national policy adviser Jeremy Hurewitz wrote that current U.S. policy is starting a "Cold War-like state of competition with China [...] with new restrictions on semiconductors and other advanced manufacturing." 

"On the business side, U.S. companies are increasingly decoupling their supply chains from China to better manage the risk of this new era," he wrote. "We'll see more examples of these policies from both government and business in the coming months."

Both the American Journal of Managed Care and the Center for Infectious Disease Research and Policy wrote posts about the potential effects that rising international tensions could have on the medical supply chain. 

https://www.beckershospitalreview.com/supply-chain/shot-down-chinese-balloon-may-affect-us-medical-supply-chain.html

Net Beneficiary Of The Ukraine War Is China

 On The Hoover Institution's 'Goodfellows' podcast, historian Niall Ferguson and other panelists discussed the continuing war in Ukraine and how it benefits China in the long run.


"There's a more interesting question Victor that I have for you and that relates the Ukraine War to the attempt to improve relations with China," Ferguson said. "I think it is Dawning on people in Washington that the net beneficiary the number one net beneficiary of the war in Ukraine is in fact China, because although we thought cleverly we were bleeding Russia dry with Ukrainian Manpower and Western weapons in practice we're running down down our own stocks of weapons. And what's China's uh position? It gets Russian oil at very steeply discounted prices and it can sell all kinds of things to Russia Chinese exports to Russia are way up as long as it stays on the right side of our sanctions line."

"I think what they've realized is that this isn't working out quite as planned and they need to rethink their overall geopolitical strategy and one way of doing that is to try to improve relations with China," he said. "We can't know what's going on in Beijing that's a completely closed black box but I think we can tell a little bit better what's going on in Washington and what I see is a realization that that the grand strategy of the Biden Administration has got us into a pretty hard to stop ear, uh albeit one that we're fighting by proxy, but it's created a real vulnerability in the rest of the world. Not only in East Asia but also in the Middle East and I think the administration is legitimately worried that one more crisis in one of those places is going to make the situation very difficult indeed."