Beyond Obamacare - health care news from around the Internet

What else has been happening recently in health care policy besides the King v. Burwell ruling? Below are links to a few recent articles of interest along with some thoughts on an underlying theme behind much of the recent news – the need to improve health care quality.

J&J vaccine completely prevented HIV in half of monkeys in trial

Quick Summary: A Johnson & Johnson vaccine prevented HIV infection in half of a group of monkeys in a research trial. The monkeys were exposed to a very potent and aggressive form of the virus that produces an infection rate about 100 times greater than that seen in humans. These promising results have led the company to plan to begin clinical trials in humans.

Food for thought: An HIV vaccine would be a major tool in HIV prevention. But what would marketing for the vaccine look like in the U.S.? The HPV vaccine, which protects against the virus that causes cervical cancer, faced the "not my kid" barrier, where parents felt that their children would not engage in sexual activity, or at least the type of sexual activity that would infect them with HPV, and therefore did not need the vaccine. Would an HIV vaccine encounter the same reaction?

Unfortunately, even after thirty plus years, HIV is still heavily stigmatized and associated with specific populations, despite the fact that the risk factors for HIV cut across all groups. That stigma could play a major role in the uptake of a vaccine.

The quality aspect of the issue is that education around HIV needs to be a major part of the future of any HIV vaccine. Providers need to be able to tactfully talk to patients about HIV and about the value of the vaccine, even if patients think they are not at risk.

Possible Link Between Eye Color and Alcoholism Risk Revealed in New Study

Quick Summary: This study found that people with lighter colored eyes, particularly blue eyes, seemed to develop alcoholism at a higher rate than others. The study authors acknowledge the complexity of alcoholism beyond genetics, but also are looking for clinical applications of their work.

Food for thought: The issue this raises for health care quality is that if eye color or other physical traits are used as a substitute for diagnosis, then assumptions may be made about people with certain traits. Additionally, people who are suffering from alcoholism and do not have the physical trait may not get the help they need. While understanding the link between different genetic traits is important, keeping the complexity of conditions like alcoholism in mind is important in delivering high quality healthcare.

Children at detention center given adult doses of hepatitis A vaccine

Quick Summary: At the South Texas Family Residential Center, an immigration detention center, 250 immigrant children were vaccinated with an adult dose of a hepatitis A vaccine. Bad reactions to the vaccine are not expected, but the children will be monitored for side effects.

Food for thought: Although, thankfully, side effects are not expected, this incident raises important issues concerning health care quality. How does an event like this impact the trust that families have in the staff at detention centers? How is an event like this perceived by immigrants in general? Does it reflect poorly on the U.S. healthcare system on an international level?  Incidents of poor quality can have many different repercussions.

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Marcelo H. Fernandez-Viña is a third-year law student at Drexel's Thomas R. Kline School of Law, concentrating in health law.

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