A summary of Digital Health Space, my other Blog

Title: Revolutionizing Healthcare: Exploring the Digital Health Space

Introduction:

In recent years, the healthcare industry has witnessed a dramatic transformation with the advent of digital health technologies. From wearable devices and telemedicine to health tracking apps and artificial intelligence, the digital health space is revolutionizing the way we approach healthcare. In this blog, we will delve into the exciting developments and key trends shaping the digital health landscape.

Wearable Devices and Remote Monitoring:

Wearable devices, such as fitness trackers, smartwatches, and biosensors, have become increasingly popular in the digital health space. These devices enable individuals to monitor their health and fitness levels in real-time, providing valuable insights into their well-being. Remote monitoring has also gained traction, allowing healthcare professionals to remotely track patients' vital signs, detect abnormalities, and intervene when necessary. We will explore the impact of wearable devices and remote monitoring on preventive care and personalized medicine.

Telemedicine and Virtual Care:

Telemedicine has emerged as a game-changer, especially in the wake of the COVID-19 pandemic. Virtual consultations and remote healthcare services have become the new norm, providing convenient and accessible care to patients. We will discuss the benefits and challenges of telemedicine, including improved access to healthcare, reduced costs, and potential limitations, such as the digital divide and privacy concerns.

Health Tracking Apps and Personalized Medicine:

Mobile applications dedicated to health tracking and wellness have gained immense popularity. These apps allow users to monitor their diet, exercise, sleep patterns, mental health, and more. Furthermore, they facilitate the collection of real-world data, which can be leveraged for research and development of personalized medicine. We will explore the potential of health tracking apps in promoting preventive care, disease management, and individualized treatment plans.

Artificial Intelligence and Machine Learning:

Artificial intelligence (AI) and machine learning (ML) are driving significant advancements in the digital health space. AI algorithms can analyze vast amounts of medical data, identify patterns, and assist in diagnosis, prognosis, and treatment decisions. ML models can predict disease outcomes, identify high-risk patients, and optimize healthcare workflows. We will delve into the transformative potential of AI and ML in enhancing patient care, drug discovery, and population health management.

Data Security and Privacy:

With the proliferation of digital health technologies comes the need to address data security and privacy concerns. The collection and storage of sensitive health information raise ethical and legal implications. We will discuss the importance of robust data protection measures, compliance with regulations such as HIPAA, and the role of blockchain technology in ensuring secure sharing and access to health data.

Future Trends and Challenges:

Finally, we will explore emerging trends and challenges in the digital health space. This includes the integration of genomics and precision medicine, the rise of health-focused wearables, the role of big data analytics, the impact of Internet of Medical Things (IoMT), and the need for regulatory frameworks to keep pace with technological advancements.

Conclusion:

The digital health space is transforming healthcare delivery, empowering individuals, and improving patient outcomes. From wearable devices to AI-driven solutions, the possibilities are endless. In this blog, we have provided an overview of the key aspects of the digital health space, highlighting its potential to revolutionize the healthcare industry. As technology continues to evolve, it is crucial to navigate the ethical, legal, and practical challenges to harness the full potential of digital health for the benefit of individuals and society as a whole.

health train express

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Health Train Express is a popular healthcare blog that provides insightful articles, news, and analysis on various topics related to healthcare. The blog covers a wide range of subjects, including healthcare policy, medical technology, patient care, healthcare economics, and industry trends. It aims to keep healthcare professionals, policymakers, and the general public informed about the latest developments and issues in the healthcare field.

The blog's content is written by experienced healthcare professionals, researchers, and experts in the industry. They offer their expertise and perspectives on current healthcare issues, providing valuable insights and thought-provoking discussions.

Some common topics covered on Health Train Express may include:

Healthcare Policy and Reform: The blog explores the impact of healthcare policies and reforms on the industry and discusses the challenges and opportunities they present.

Medical Technology and Innovations: Health Train Express highlights the latest advancements in medical technology, such as telemedicine, robotics, artificial intelligence, and wearable devices, and examines their potential to improve patient care and outcomes.

Patient Care and Safety: The blog emphasizes the importance of patient-centered care, sharing best practices, and discussing strategies to enhance patient safety and quality of care.

Healthcare Economics and Finance: Health Train Express delves into the economic aspects of healthcare, including healthcare financing, reimbursement models, cost containment, and the impact of healthcare expenditures on the overall economy.

Healthcare Delivery and Organization: The blog explores different healthcare delivery models, such as accountable care organizations (ACOs) and patient-centered medical homes (PCMHs), and analyzes their effectiveness in improving care coordination and population health.

Healthcare Technology Adoption: Health Train Express examines the challenges and benefits of adopting new technologies in healthcare settings, addressing issues such as interoperability, data privacy, and the integration of electronic health records (EHRs).

Public Health and Health Promotion: The blog covers public health initiatives, preventive medicine, disease surveillance, and community health programs aimed at improving population health and reducing healthcare disparities.

Health Train Express strives to provide evidence-based information and foster constructive discussions on important healthcare topics. It serves as a valuable resource for healthcare professionals, policymakers, students, and anyone interested in staying informed about the latest developments in the healthcare industry.

Health Justice Monitor – Medicare Advantage: How Private Insurers Exploit Medicare

Medicare Advantage: How Private Insurers Exploit Medicare

An excellent interview with the former head of CMS, which oversees Medicare, lays out how Medicare Advantage insurers manipulate costs and quality, grabbing massive profits from public funds with no clinical benefits for patients. He wants its growth stopped and its problems fixed.

March 2, 2024

Obama CMS Chief: Medicare Advantage Plans Game the System
MedPage Today
March 1, 2024
by Cheryl Clark

(HJM bolding)

Donald Berwick, MD, MPP was the administrator of the Centers for Medicare & Medicaid Services (CMS) during the Obama administration and is president emeritus and senior fellow at the Institute for Healthcare Improvement.

MedPage Today interviewed him about his concerns that too many Medicare beneficiaries are being misled into enrolling into private Medicare Advantage plans, which he said should be slowed or stopped because the plans have gamed the system to receive billions more than what is spent for traditional Medicare beneficiaries’ care.

Cheryl Clark: Medicare Advantage, or MA, plan enrollment has been growing so fast; 52% of beneficiaries are now enrolled, with 60%, 70% projected in a few years. … I hear a traditional Medicare patient can’t find a primary care provider in some parts of the country because all the doctors are locked in MA.

Will every eligible beneficiary have no choice but Medicare Advantage? … And is that a good idea, given your concern about how MA plans have gamed the system to get more money?

Berwick: I think MA growth should be slowed or stopped, at least until we end the extraordinarily high subsidies for MA plans, which are unfair to traditional Medicare and burdensome to the public treasury and many beneficiaries. Many beneficiaries can get better care for themselves and greater choice through traditional Medicare, and that option should remain robust and available. …

Clark: Let’s talk about … how MA plans are overpaid. They’ll receive $88 billion more this year than what is spent for the same patients in traditional Medicare. That is a huge concern. But I don’t think it’s clear to readers how the plans are paid, that it’s not necessarily for better care.

Berwick: It’s a really complicated process and, I must say, possibly intentionally so, because I think it serves the interests of the private plans to have payment rules that are so hard to understand.

What the benchmark begins with is a comparison to the traditional Medicare population: people like me, who are in fee-for-service, traditional Medicare. There’s a calculation of the cost of my expected care… based on demographics and county, because care is more expensive in some counties than others. ..

Most importantly, the amount that an MA plan gets is adjusted for the number of codes for diagnoses that a beneficiary has, like atrial fibrillation or diabetes, and for each code the plan gets more money, supposedly reflecting the additional care the patient needs. And that’s where the gaming nonsense occurs. Many codes have no real implications at all for evidence-based clinical care, but they carry with them extra payment nonetheless. The coding system has created opportunities for these plans to upcode. They comb through patients’ histories and try to stuff in as many diagnoses as they possibly can, even if they have nothing to do with the care of the patient.

Clark: During a January 12 MedPAC meeting, one of the commissioners mentioned that the plans were paying doctors to go through each record and look for anything that could add to capitated payment.

Berwick: That’s right. That’s worth a bit of a dive. There are three ways health plans manipulate the coding processes. What they’re after is what you said, which is, comb through the patient’s record, send a nurse into the patient’s home to find additional diagnoses. Sometimes, in some of the MA systems, they actually pay the doctor to code using a software package the insurance plan gives to the doctor. …

And a third and now much more popular, certainly to insurers, is to simply employ the doctors. Once the doctor is an employee, then you can set up all sorts of ways to accelerate upcoding. You can train the doctors or give them incentives to upcode. And now, the largest employer of doctors is a health plan, an MA plan. In this third tactic, the MA plan gets the benefit of all the upcoding, and that’s part of the game they are playing.

Now rather than lower costs, MA has much higher costs — something to the tune of $80 billion a year. Other estimates are as high as $120 billion. For the most part, that money doesn’t represent the needs of the patient. In fact, we know that beneficiaries in MA are, on the whole, healthier than those in traditional Medicare, and ought to cost less, not more.

It’s just a transfer of money to the private sector. Most of that goes to profit for the plan, or for stock buybacks, high compensation for plan executives, …

And further, because of all the gaming of diagnoses, it gets really, really hard to compare quality of care and outcomes between Medicare Advantage and traditional Medicare patients.

Clark: You’ve said you think MA plans should be slowed or stopped. How do you think that should happen?

Berwick: … We need to stop these abuses as quickly as possible. And we need simultaneously to improve the attractiveness of traditional Medicare, which is what tens of millions of Americans still have. …

Clark: [The MedPAC director] said that for chronic conditions, there is evidence that MA plans deliver better care.

Berwick: … There is some information that suggests that for some conditions, some MA plans do offer better chronic care but that’s a really hard statement to prove, and it certainly doesn’t apply across the board. And remember: MA plans are upcoding patients, so they make the patients look sicker, so when you try to assess outcomes, adjusted for severity, you’ve already fallen into the hole created by this game in which you’re no longer comparing apples to apples….

Clark: You spoke of the quality bonus program, which is a factor in MA capitated payments. How does it work?

Berwick: … the quality bonus system needs a big overhaul. It now has been pretty thoroughly gamed by MA plans. They focus on the scored variables, not overall better care – “teaching to the test,” as it were. Something like 80% of plans now are four-star or five-star on a five-star scale. I call that the “Lake Wobegon” effect, where everybody is above average. It’s a tricky system with unintended consequences. For example, when you’re treating a very distressed population with limited resources and there are barriers to treatment, you don’t want to take money away from the very organizations that need more money because their populations are harder to treat. But it has just become too easy to get a high score. …

The rating system is flawed and amounts to a check off the box analysis.

Other restriction for care require prior authoization for certain expensive tests, or imaging (MRI), and durable medical equipment (DME) for which they have strict limited vendors

On the other hand Advantage plans provide free transportion to senior citizens, many of which have no transportation

Caveat emptor---Let the buyer beware

 Comment by: Jim Kahn

Don Berwick is a hero for many of us, for his decades of foundational work in quality of medical care and his forthright criticism of Medicare Advantage, the private insurance arm of Medicare.

In this interview, he reviews how insurers thoroughly game the MA systems for payment and quality rating, yielding tens of billions in excess payments with no evidence of clinical benefit. Indeed, there is evidence of impaired access to care for the sickest and poorest, and financial harm to providers who treat the most needy.

You should read the entire interview, it’s wide-ranging and informative, and only a little technical. We’ll be writing more on Medicare Advantage issues in coming days.

As Dr. Berwick points out, traditional Medicare – in which the government pays providers directly – works more efficiently to assure access to care. But it needs some coverage gaps closed. That is, we need an improved traditional Medicare. Then we could extend that to everyone. That’s an “improved Medicare for All”. Aka: single payer.

About the Commentator, Jim Kahn

Jim (James G.) Kahn, MD, MPH (editor) is an Emeritus Professor of Health Policy, Epidemiology, and Global Health at the University of California, San Francisco. His work focuses on the cost and effectiveness of prevention and treatment interventions in low and middle income countries, and on single payer economics in the U.S. He has studied, advocated, and educated on single payer since the 1994 campaign for Prop 186 in California, including two years as chair of Physicians for a National Health Program California.

Health Justice Monitor – Medicare Advantage: How Private Insurers Exploit Medicare

Senators’ Latest Attempt to Enrich Big Pharma Must Not Prevail - The American Prospect

The Revolving Door Project, a Prospect partner, scrutinizes the executive branch and presidential power.

Sadly, the American patent system has drifted far from that ideal, especially in the realm of pharmaceuticals. Americans pay on average more than twice as much for prescription drugs than people in other high-income economies, while U.S.-based pharmaceutical companies are twice as profitable as companies in other sectors. The impact of high drug prices is keenly felt in Americans’ daily lives: 80 percent of adults describe drug costs as unreasonably high.

Sadly, the American patent system has drifted far from that ideal, especially in the realm of pharmaceuticals. Americans pay on average more than twice as much for prescription drugs than people in other high-income economies, while U.S.-based pharmaceutical companies are twice as profitable as companies in other sectors. The impact of high drug prices is keenly felt in Americans’ daily lives: 80 percent of adults describe drug costs as unreasonably high.

The first of these bills, PERA, would enable companies to patent things that have been off-limits for centuries because humans did not and could not invent them—namely, products of nature, natural laws, and abstract ideas. If PERA becomes law, it would allow companies to patent isolated human genes, correlations between specific genes and health conditions, and methods of using those correlations to give patients information about their health that could be critical to improving or saving their lives.

Patenting isolated genes poses a grave threat to the health and safety of the American population. Before the Supreme Court confirmed in 2013 that existing law prohibits such patents, one company, Myriad Genetics, had patents on isolated gene sequences, which are highly correlated with breast, ovarian, and prostate cancers. Myriad used its patents to prevent other laboratories from developing or offering their own tests, even those that were more comprehensive and accurate. The day the Supreme Court issued its decision in Association for Molecular Pathology v. Myriad Genetics, Inc., everything changed. Five different laboratories announced they would provide tests for those mutations for far less than Myriad had charged. Prices quickly dropped from $4,000 to between $1,000 and $2,300 per test. By bringing patents like Myriad’s back to life, PERA would also bring back exorbitant prices for diagnostic genetic tests, including those that have been critical to the fight against COVID-19.

The second bill, PREVAIL, which is co-sponsored by Senate Judiciary Committee Chair Sen. Dick Durbin (D-IL), would enable companies to keep patents that cover things that were already known or obvious to scientists in the relevant field. Currently, patents are typically required to be original, non-obvious findings—in line with the Constitution’s language about “Progress.” Coons is also engaged with the House Judiciary Subcommittee on Intellectual Property on a separate version, which aims to impose additional restrictions on procedures for challenging these problematic patents.

The currently proposed bill would protect these wrongly granted patents by restricting access to the only mechanism the public has for challenging them outside of federal court: the Patent Trial and Appeal Board (PTAB). Congress deliberately created the PTAB to make it easier, cheaper, and more efficient to invalidate wrongly granted patents. And it has been a success: 46 percent of patents challenged at the PTAB have been found invalid in whole or part.

Patents are meant to encourage actual innovation, not monster corporate profits.

That’s why the Biden administration is pushing on multiple fronts to lower drug prices. However, the administration has run into some roadblocks in the form of the pharmaceutical industry’s loyal defenders in Congress. In the Senate, two industry stalwarts, Chris Coons (D-DE) and Thom Tillis (R-NC)—both of whom were among the biggest recipients of pharma checks in Congress during their last election cycle—are lead signatories to the Biotechnology Innovation Organization–endorsed letter opposing the National Institute of Standards and Technology’s new draft guidance framework, which outlines potential uses of march-in rights to reduce prescription drug prices.

Worse, Coons and Tillis have introduced legislation that would fuel Big Pharma’s abuse of the patent system and exacerbate the drug-pricing crisis in this country. Recently, they’ve informed their colleagues that their latest attempt to push forward the misleadingly named Patent Eligibility Restoration Act (PERA) and Promoting and Respecting Economically Vital American Innovation Leadership (PREVAIL) Act has enough steam to make it out of committee. Enacting these bills, alone or together, would richly reward pharmaceutical companies for their donations, and encourage them to give more to support Coons and Tillis’s re-election bids in 2026.

The first of these bills, PERA, would enable companies to patent things that have been off-limits for centuries because humans did not and could not invent them—namely, products of nature, natural laws, and abstract ideas. If PERA becomes law, it would allow companies to patent isolated human genes, correlations between specific genes and health conditions, and methods of using those correlations to give patients information about their health that could be critical to improving or saving their lives.

Patenting isolated genes poses a grave threat to the health and safety of the American population. Before the Supreme Court confirmed in 2013 that existing law prohibits such patents, one company, Myriad Genetics, had patents on isolated gene sequences, which are highly correlated with breast, ovarian, and prostate cancers. Myriad used its patents to prevent other laboratories from developing or offering their own tests, even those that were more comprehensive and accurate. The day the Supreme Court issued its decision in Association for Molecular Pathology v. Myriad Genetics, Inc., everything changed. Five different laboratories announced they would provide tests for those mutations for far less than Myriad had charged. Prices quickly dropped from $4,000 to between $1,000 and $2,300 per test. By bringing patents like Myriad’s back to life, PERA would also bring back exorbitant prices for diagnostic genetic tests, including those that have been critical to the fight against COVID-19.

The second bill, PREVAIL, which is co-sponsored by Senate Judiciary Committee Chair Sen. Dick Durbin (D-IL), would enable companies to keep patents that cover things that were already known or obvious to scientists in the relevant field. Currently, patents are typically required to be original, non-obvious findings—in line with the Constitution’s language about “Progress.” Coons is also engaged with the House Judiciary Subcommittee on Intellectual Property on a separate version, which aims to impose additional restrictions on procedures for challenging these problematic patents.

The currently proposed bill would protect these wrongly granted patents by restricting access to the only mechanism the public has for challenging them outside of federal court: the Patent Trial and Appeal Board (PTAB). Congress deliberately created the PTAB to make it easier, cheaper, and more efficient to invalidate wrongly granted patents. And it has been a success: 46 percent of patents challenged at the PTAB have been found invalid in whole or part.

Naturally, Big Pharma hates this board. Gutting government capacity with the elimination of PTAB would only allow for an explosion of wrongly granted patents, which are crucial to pharma’s ability to block competition and lock in exorbitant prices for decades.

Two of the biggest supporters of these bills are former U.S. Patent and Trademark Office (USPTO) directors David Kappos and Andrei Iancu. This is no surprise. Since leaving their roles, Kappos and Iancu have committedly opposed efforts to remodel our clearly anti-competitive patent system. What’s more, the former directors advocate loudly for changing the law while remaining silent about the corporate interests they represent. After leaving the USPTO, David Kappos joined the partnership of Cravath, Swaine & Moore, which represents Amgen, Johnson & Johnson, and Novartis, among other pharma heavyweights. Iancu is now a partner at Sullivan & Cromwell, which lists AbbVie, Bayer, and Merck among its life sciences clients. He also founded the Council for Innovation Promotion as an outfit to more systematically support the entrenchment of the current anti-competitive system.

The former directors’ current roles reveal the other primary beneficiaries of the proposed bills: law firms and lawyers. Patent litigation is big business, with costs ranging from $2 to $4 million per case on average. But recently, patent litigation rates have begun to decline sharply. Given the business they stand to lose, it’s no wonder that law firm partners are pushing for changes that would ensure more patents are granted and litigated in court. Lawyers have every right to advocate for their own interests and those of their clients. But when they do, they should be transparent about it, instead of using the veneer of their former roles in the public sector to paint their positions as anything other than advocacy on behalf of their corporate clients’ interests.

The patent system exists to promote scientific innovation to benefit the public, not to enrich private interests regardless of the merits of their scientific contributions. Yet that is precisely what PERA and PREVAIL would do by granting Big Pharma even more sweeping government monopolies and associated price-gouging power. We hope the senators who have shown their willingness to stand up to Big Pharma will stand up to their colleagues’ efforts to reward their benefactors.

Senators’ Latest Attempt to Enrich Big Pharma Must Not Prevail - The American Prospect

Harvard Tramples the Truth | City Journal

Martin Kulldorff is a former professor of medicine at Harvard University and Mass General Brigham. He is a founding fellow of the Academy for Science and Freedom.

The Harvard motto is Veritas, Latin for truth. But, as I discovered, truth can get you fired. This is my story—a story of a Harvard biostatistician and infectious-disease epidemiologist, clinging to the truth as the world lost its way during the Covid pandemic.

The chutzpah of the elitists and the isolation of higher education is revealed by the following.

On March 10, 2020, before any government prompting, Harvard declared that it would “suspend in-person classes and shift to online learning.” Across the country, universities, schools, and state governments followed Harvard’s lead.

Many look to ivory tower expertise, and many times they come away disappointed, or misled.

Yet it was clear, from early 2020, that the virus would eventually spread across the globe, and that it would be futile to try to suppress it with lockdowns. It was also clear that lockdowns would inflict enormous collateral damage, not only on education but also on public health, including treatment for cancer, cardiovascular disease, and mental health. We will be dealing with the harm done for decades. Our children, the elderly, the middle class, the working class, and the poor around the world—all will suffer.

Schools closed in many other countries, too, but under heavy international criticism, Sweden kept its schools and daycares open for its 1.8 million children, ages one to 15. Why? While anyone can get infected, we have known since early 2020 that more than a thousandfold difference in Covid mortality risk holds between the young and the old. Children faced minuscule risk from Covid, and interrupting their education would disadvantage them for life, especially those whose families could not afford private schools, pod schools, or tutors, or to homeschool.

What were the results during the spring of 2020? With schools open, Sweden had zero Covid deaths in the one-to-15 age group, while teachers had the same mortality as the average of other professions. Based on those facts, summarized in a July 7, 2020, report by the Swedish Public Health Agency, all U.S. schools should have quickly reopened. Not doing so led to “startling evidence on learning loss” in the United States, especially among lower- and middle-class children, an effect not seen in Sweden.

Sweden was the only major Western country that rejected school closures and other lockdowns in favor of concentrating on the elderly, and the final verdict is now in. Led by an intelligent social democrat prime minister (a welder), Sweden had the lowest excess mortality among major European countries during the pandemic, and less than half that of the United States. Sweden’s Covid deaths were below average, and it avoided collateral mortality caused by lockdowns.

Yet on July 29, 2020, the Harvard-edited New England Journal of Medicine published an article by two Harvard professors on whether primary schools should reopen, without even mentioning Sweden. It was like ignoring the placebo control group when evaluating a new pharmaceutical drug. That’s not the path to truth.

That spring, I supported the Swedish approach in op-eds published in my native Sweden, but despite being a Harvard professor, I was unable to publish my thoughts in American media. My attempts to disseminate the Swedish school report on Twitter (now X) put me on the platform’s Trends Blacklist. In August 2020, my op-ed on school closures and Sweden was finally published by CNN—but not the one you’re thinking of. I wrote it in Spanish, and CNN–Español ran it. CNN–English was not interested.

I was not the only public health scientist speaking out against school closures and other unscientific countermeasures. Scott Atlas, an especially brave voice, used scientific articles and facts to challenge the public health advisors in the Trump White House, National Institute of Allergy and Infectious Diseases director Anthony Fauci, National Institutes of Health director Francis Collins, and Covid coordinator Deborah Birx, but to little avail. When 98 of his Stanford faculty colleagues unjustly attacked Atlas in an open letter that did not provide a single example of where he was wrong, I wrote a response in the student-run Stanford Daily to defend him. I ended the letter by pointing out that:

Black listed by X, and peers at Harvard, supposedly a bastion of intellect and academic freedom. He faced more black listing;

 et on July 29, 2020, the Harvard-edited New England Journal of Medicine published an article by two Harvard professors on whether primary schools should reopen, without even mentioning Sweden. It was like ignoring the placebo control group when evaluating a new pharmaceutical drug. That’s not the path to truth.

That spring, I supported the Swedish approach in op-eds published in my native Sweden, but despite being a Harvard professor, I was unable to publish my thoughts in American media. My attempts to disseminate the Swedish school report on Twitter (now X) put me on the platform’s Trends Blacklist. In August 2020, my op-ed on school closures and Sweden was finally published by CNN—but not the one you’re thinking of. I wrote it in Spanish, and CNN–Español ran it. CNN–English was not interested.

I was not the only public health scientist speaking out against school closures and other unscientific countermeasures. Scott Atlas, an especially brave voice, used scientific articles and facts to challenge the public health advisors in the Trump White House, National Institute of Allergy and Infectious Diseases director Anthony Fauci, National Institutes of Health director Francis Collins, and Covid coordinator Deborah Birx, but to little avail. When 98 of his Stanford faculty colleagues unjustly attacked Atlas in an open letter that did not provide a single example of where he was wrong, I wrote a response in the student-run Stanford Daily to defend him. I ended the letter by pointing out that:

Among experts on infectious disease outbreaks, many of us have long advocated for an age-targeted strategy, and I would be delighted to debate this with any of the 98 signatories. Supporters include Professor Sunetra Gupta at Oxford University, the world’s preeminent infectious disease epidemiologist. Assuming no bias against women scientists of color, I urge Stanford faculty and students to read her thoughts.

None of the 98 signatories accepted my offer to debate. Instead, someone at Stanford sent complaints to my superiors at Harvard, who were not thrilled with me.

I had no inclination to back down. Together with Gupta and Jay Bhattacharya at Stanford, I wrote the Great Barrington Declaration, arguing for age-based focused protection instead of universal lockdowns, with specific suggestions for how better to protect the elderly, while letting children and young adults live close to normal lives.

With the Great Barrington Declaration, the silencing was broken. While it is easy to dismiss individual scientists, it was impossible to ignore three senior infectious-disease epidemiologists from three leading universities. The declaration made clear that no scientific consensus existed for school closures and many other lockdown measures. In response, though, the attacks intensified—and even grew slanderous. Collins, a lab scientist with limited public-health experience who controls most of the nation’s medical research budget, called us “fringe epidemiologists” and asked his colleagues to orchestrate a “devastating published takedown.” Some at Harvard obliged.

A prominent Harvard epidemiologist publicly called the declaration “an extreme fringe view,” equating it with exorcism to expel demons. A member of Harvard’s Center for Health and Human Rights, who had argued for school closures, accused me of “trolling” and having “idiosyncratic politics,” falsely alleging that I was “enticed . . . with Koch money,” “cultivated by right-wing think tanks,” and “won’t debate anyone.” (A concern for those less privileged does not automatically make you right-wing!) Others at Harvard worried about my “scientifically inaccurate” and “potentially dangerous position,” while “grappling with the protections offered by academic freedom.”  

Though powerful scientists, politicians, and the media vigorously denounced it, the Great Barrington Declaration gathered almost a million signatures, including tens of thousands from scientists and health-care professionals. We were less alone than we had thought.

Even from Harvard, I received more positive than negative feedback. Among many others, support came from a former chair of the Department of Epidemiology

Great Barrington Declaration

Harvard Tramples the Truth | City Journal

Review of Topics in the Health Train Express

Certainly! The healthcare policy space encompasses a wide range of topics that are often discussed and debated. Some typical topics in the healthcare policy space include:

Healthcare Access and Coverage: Discussions revolve around policies aimed at expanding access to healthcare services, increasing insurance coverage, and reducing barriers to care for underserved populations. This includes topics such as Medicaid expansion, health insurance marketplaces, and initiatives to address the uninsured population.

Healthcare Reform and Legislation: This involves discussions on major healthcare reform efforts, such as the Affordable Care Act (ACA) in the United States or similar healthcare reform efforts in other countries. It includes debates on the structure of the healthcare system, insurance market reforms, and healthcare delivery models.

Healthcare Quality and Patient Safety: Topics under this category focus on policies and strategies aimed at improving the quality of healthcare services and ensuring patient safety. This includes initiatives to reduce medical errors, promote evidence-based practices, and enhance care coordination.

Healthcare Costs and Affordability: Discussions on healthcare costs often center around policies addressing the rising costs of healthcare services, prescription drugs, and health insurance premiums. Topics in this area may include cost containment measures, value-based care, drug pricing, and strategies to promote cost transparency.

Health Information Technology and Interoperability: This topic explores policies related to health information technology adoption, electronic health records (EHRs), interoperability standards, and data exchange. Discussions may focus on promoting interoperability, protecting patient privacy, and leveraging health IT for improved care coordination.

Payment and Reimbursement Models: Policy discussions in this area revolve around payment and reimbursement models for healthcare services, including fee-for-service, value-based care, bundled payments, and alternative payment models. The aim is to align financial incentives with improved patient outcomes and cost-effective care.

Public Health and Prevention: Topics related to public health policies include initiatives to prevent and control diseases, promote vaccinations, address population health disparities, and implement public health campaigns. It may also cover policies related to tobacco control, obesity prevention, and environmental health.

Health Equity and Social Determinants of Health: These discussions focus on policies aimed at reducing health disparities and addressing the social determinants of health, such as poverty, education, housing, and access to healthy food. It involves exploring strategies to promote health equity and ensure equitable access to healthcare services.

These topics are not exhaustive, and healthcare policy discussions are continuously evolving as new challenges and priorities emerge. It's important to note that healthcare policy varies across countries and regions, so the specific topics and policy issues may differ based on the context.

health train express