5-Star Friday: Illuminating darkness

5-star, candle, light, darkness, vision, blindness

As we approach the darkest day of the year we’re reminded that not infrequently — as health care journalists — we are called upon to write about dark topics. Such topics take us to painful places that are often neglected, but some writers feel compelled to delve into.

They’re not easy stories to write, but they’re clearly important to share.

The excellent journalism we highlight below exemplifies this. It doesn’t just take courage and tenacity to take on the stories these reporters have, it takes a great deal of sensitivity as well.

We admire that, and think that as the year comes to a close, these are stories worth reading and reflecting on.

Joy Victory | Deputy Managing Editor

Nothing Protects Black Women From Dying in Pregnancy and Childbirth • by Nina Martin, ProPublica, and Renee Montagne, NPR

Written in the near-aftermath of the death of high-achieving CDC epidemiologist Shalon Irving, this expansive piece tackles one of the most striking disparities in health care today with poignancy and grace. Black women face more pregnancy-related health risks–and more barriers to quality care–than women of other races, and not even being a top health scientist like Irving provides immunity. The article does a phenomenal job of explaining why, even diving into the public health concept of “weathering” chronic stress and its physical and genetic effects on the body.

But the story also tackles another important facet of the nation’s increasing maternal mortality rate: How half of women die seven or more days after delivery. As anyone who has given birth knows, most of us have minimal health care during this period, and we must white-knuckle it through many tough moments until our 6-week follow-up appointment. There is little safety net for any woman, but especially a black woman:

Meanwhile, many providers wrongly assume that the risks end when the baby is born — and that women who came through pregnancy and delivery without problems will stay healthy. In the case of black women, providers may not understand their true biological risks or evaluate those risks in a big-picture way.”

Jill Adams | Associate Editor

He Took Opioids To Manage His Chronic Pain. When His Doctors Took Them Away, He Didn’t Want To Live Anymore • by Dan Vergano • BuzzFeed

New CDC guidelines encourage doctors to stop using opioids for chronic pain.

Some patients have successfully weaned themselves from opioids and are in less pain. Others have fared far worse:

Some doctors are abruptly ending prescriptions even when patients have been stable on high doses for years, throwing them into withdrawal — a soul-rending mix of nausea, agony, depression, and sometimes worse.

BuzzFeed’s Dan Vergano tells a tale of one man who contemplated suicide. This anecdote is grounded in a wide-ranging and well-researched story that ultimately reveals the appalling lack of good medical care for people with chronic pain.

Gary Schwitzer

Gary Schwitzer | Publisher-Founder

Months After Approval, Breakthrough Cancer Drug Given to Just Five Patients • by Michelle Cortez, Caroline Chen and Natasha Rausch • Bloomberg

How could this be?  15 hospitals authorized to give the drug, a new CAR-T drug with the brandname Yescarta.  Waiting lists of at least 200 people.  Some die waiting.

As the Bloomberg team reports, there are several factors, including: the $373,000 treatment cost; insurance issues, including with Medicare and Medicaid; other issues confronted when a new treatment, like Yescarta, arrives on the scene.

Key excerpt:

Yescarta and Novartis AG’s Kymriah were only approved in the last several months. Because CAR-Ts are so new — and because the one-time, bespoke therapies involve a blend of hospital care, boutique biological manufacturing and supplemental drugs to guide patients through the treatments — insurers and government plans have found themselves in uncharted territory.

Michael Joyce | Writer-Producer

Prescription Drugs May Cost More With Insurance Than Without It • by Charles Ornstein & Katie Thomas • ProPublica & NYTimes

Michael Joyce

Although this may not be news to some, kudos to ProPublica and the Times for joining forces to put this on the radar of many more people.

Whether you’re on a prescription drug or not, it’s worth knowing the diverse group of players largely responsible for determining drug prices in the United States. Just as it’s worth hearing from Michael Rea at Rx Savings Solutions, who’s quoted in the piece as saying:

[The system has become so complex] that there’s no chance that a consumer can figure it out without help.

Thomas and Ornstein provide that help and paint a compelling picture of a drug pricing future in which — when you take into account the variety of medical insurers available, and wide range of co-payments many of us face — it just may come to a point where no two people are paying the same price, for the same drug.

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