Latest news with #inequity
Yahoo
29-06-2025
- Health
- Yahoo
Dr. Loh: In the crosshairs — American healthcare leadership
In these unpredictable times in healthcare, it seems that an overview of where we are, how we got here, and where we go from here, might be worthwhile before going back to dealing with the implications of some of the shortsighted policies instigated by whim and ignorance by people placed into positions of great power based on fealty rather than competence. Unfortunately, it is the public and their progeny that have to deal with the consequences. If you do not agree with these statements, remember this is an opinion article. Feel free to express yours in this forum. An informed dialogue is good for a democracy. Childish behavior, bullying, and yelling, are not. America has traditionally led in the fields of biomedical research and technology, as well as in the basic sciences that underpin those advances. All of humanity has potentially benefited from our medical research. Yet our outcomes do not track with the quality of our medical science, e.g., maternal mortality, lifespan, etc. Some of this is explainable by lifestyle choices. But another contributor is the well-documented problem that in the U.S., getting access to that fantastic care is inequitable and affected by one's income, social status, and zip code. This is why despite having the best biomedical science, we have third-world outcome data for some of the actual care being delivered. Having profit-driven middle-man insurance and pharmaceutical benefit manager companies placed between a human being that needs care, and a trained clinician capable of doing that care only exacerbates the disparity between what is possible and what is probable. Some of these factors have been called the social determinants of health, and are quite unpopular now in hallways of American power, so it is quite unlikely that there will be any meaningful movement towards correcting these issues. It's easier to blame an immigrant, legal or otherwise, or a single mother, minority or otherwise, trying to care for her family, than to look in the mirror to see where the real problems are. Those of you who have followed my columns for decades know that I recently cut back from clinical practice after 45 years, but that I have been a clinical researcher for over 50 years. Over these years, I've seen healthcare make many changes, driven by financial pressures on the federal government to deliver affordable healthcare, and to not undermine the for-profit insurance industry. Increased taxes (by many names) and decreased benefits (by many health plans) have been the 'adjustments' required to try and keep an unsustainable healthcare system functional. They did this by kicking the financial can down the road so that the next Congress and next administration would have to deal with it. This has, by the way, been going on since around WWI (one!) from the time of Woodrow Wilson. The current administration, through DOGE, and its selection of individuals uniquely and unequivocally unfit for their healthcare positions, has embarked on a wholesale dismemberment of our healthcare system. This is not to make it more efficient as they claim, but to cut the biggest costs (healthcare) out of our federal budget so that the uber-wealthy can keep their tax cuts due to expire soon. And yet the proposed Big Beautiful Bill will jack our national debt to even more obscene levels, to be borne by our children and children's children. We are the only allegedly civilized country that regularly drives its citizens into bankruptcy because of the cost of getting healthcare. And our Congressional and Senate leadership have been complicit in this. Indeed, the proposed cuts to Medicaid are likely, if implemented, to break the financial back of many smaller rural American hospitals that are barely getting by now and consequently exacerbating the difficulties in getting access to care. Through coarse Draconian budgetary slashes, DOGE and Congress have laid waste to the NIH, academic and myriad basic science labs in the U.S. as well as those sponsored by partner labs around the world. As a result, we are not only losing the science that has made American biomedical research the envy of the world, we are losing the next generation of scientists who have lost their funding. Some of the best and brightest biomedical minds are being poached by academic institutions, basic science labs and pharmaceutical labs from around the world. These scientists are vulnerable since they want to continue to do the work to which they have dedicated their lives and have been trained to do. That work is what drives progress in understanding and treating the chronic diseases that MAHA purports to support, but clearly does not understand how it it done. Many of the new investigational products I am being offered and am seeing at my research site, are the products of basic science work increasingly coming from sources outside the U.S. More clinical trials are now being done outside the U.S. than within. In the past, these developments would have been welcome as evidence of the collaboration clinical scientists have enjoyed for decades. Much of it because many of their scientists were trained here, developed their post-graduate careers here, stayed and have been immensely productive. Some inevitably return home to build labs and continue to do the science there and train new colleagues. This is the nature of America's soft power, the intellectual and moral inculcation of the best minds into what truly made America great. Now the shift is more ominous because young foreign investigators are feeling targeted and being made to feel unwelcome. Science does not care about your gender, race, ethnicity, politics, or religious preference, if any. It is the pursuit of new knowledge, ideally for the benefit of humankind. How humans use that knowledge is another topic, and is where it intersects with political considerations. And what is going on in Washington, D.C., now is Exhibit A. And the solution to all of this tumult is in our collective hands as long as we are able to have free elections. Irving Kent Loh, M.D., is a preventive cardiologist and the director of the Ventura Heart Institute in Thousand Oaks. Email him at drloh@ This article originally appeared on Ventura County Star: Dr. Loh: In the crosshairs — American healthcare leadership
Telegraph
14-06-2025
- Health
- Telegraph
NHS boss claims Nigerian mother got the ‘black service'
An NHS boss has claimed his Nigerian mother received the 'black service, not an NHS service' after dying from suspected lung cancer. Lord Victor Adebowale, chairman of the NHS Confederation, which represents all health organisations, said the death of his 92-year-old mother was 'undignified'. His mother Grace, who worked as an NHS nurse for 45 years, died in January, possibly from lung cancer, but it was not detected until after she died. Lord Victor said there were 'too many situations where people that look like me and shades of me don't get the service'. 'It was not the dignified death that we would have wanted for her. It wasn't the death she deserved,' he told the NHS ConfedExpo conference in Manchester. 'So it makes me clear about the need to address the inequity. I think she got a black service, not an NHS service.' Mrs Adebowale emigrated from Nigeria to Scotland in the 1950s and worked as a nurse across mental health, maternity and acute care, during her career. Lord Victor, who grew up in Wakefield, said that he did not want to blame anyone for her death as the details were not yet clear, but he said that he wanted to highlight a 'systematic problem'. 'She lived to the age of 92 and you may think, 'well, she had a good old innings', but for a lot of those years she was in some discomfort, and it looks like she died from cancer,' he said. 'It's still the case that if you look like me, you're more likely to discover that you've got cancer in A&E, and that for me is an example of two different services.' 'Black people have worse outcomes' He added: 'I used the phrase 'black service'... you only have to look at the stats – across all the major disease categories that we talk about, black people have a worse experience and worse outcomes – we've known that for years, I'm not saying anything new.' He said his mother was an example of a wider issue and he was 'sick of it not changing like everyone else, and I'm close enough to it to know that it happens'. He said there was nothing in his mother's medical records to suggest she had cancer, and that she had gone to A&E in 'poor condition' at a hospital that 'was really struggling when she went in'. Lord Victor said his sister had to argue for their mother to be given a room but that they had not found the reason for her death yet. 'We haven't got to the bottom of it, and that's why I'm not blaming anybody, and I don't want to, but I can talk about my experience and my observation of what happened to my mum,' he said. 'How does that happen? I know it does happen. People have chronic diseases and people don't know and they die of them – I know it's more likely to happen if you're black, it's also more likely to happen if you're poor.' Of his mother, whose full name was Grace Amoke Owuren Adebowale, and who worked in various nursing sectors including mental health, acute care and maternity, he said: 'If you are a nurse, it is what you are, it's what you're born to do.' He went on: 'It is not acceptable that someone who looks like me, on average waits 20 minutes longer in A&E than white patients.' Kate Seymour, head of external affairs at Macmillan Cancer Support, said the story highlighted 'the heartbreaking reality for some when it comes to accessing cancer care in this country'. 'It is categorically unacceptable that some people with cancer are having worse experiences simply because of who they are or where they live. The Government in England has a unique opportunity in its upcoming cancer plan to revolutionise cancer care,' she said. An NHS spokesperson said: 'Everyone – no matter their background – should receive the best NHS care possible. 'That's why we are working across the NHS to ensure that happens – from improving access to cancer diagnosis and treatment, to expanding health checks for Black and Asian communities and increasing uptake of blood pressure and cholesterol medication in under-served groups. 'But we know there is much more to do, and tackling health inequalities will form an important part of the upcoming 10 Year Health Plan.'
