Understand how science, health policy, and medicine shape the world everyday. Sign up for our Morning Rounds newsletter here.
Buongiorno, Nalis here! A question for you to consider: Is it fair to let the Sacklers off the hook from facing future justice, if that is the best guarantee of compensation to victims of the opioid epidemic? Don’t worry if you’re not sure; the Supreme Court doesn’t seem to know either. Another hard question: mRNA vaccines for the seasonal flu — yes, or no? Keep reading to find out more, and send us your thoughts.
Supreme Court appears torn over Purdue case
The Supreme Court heard arguments on Monday about whether the Sackler family, the owner of Purdue Pharma, could be shielded from future civil lawsuits under the terms of their bankruptcy deal. As part of the deal, the Sacklers would pay up to $6 billion toward compensating people affected by the opioid crisis and, in exchange, would not face personal liability in the future.
The court has to decide whether the bankruptcy court has authority to approve such a plan, but beyond the legal matter is the question of how much the Sacklers should pay — financially and otherwise. Complicating the issue is the fact that the vast majority of the plaintiffs agree to the settlement, which they see as a faster and surer way to get compensation. Opponents to the agreement, however, say that current plaintiffs don’t have the right to decide on behalf of pos
sible future ones. The court appeared divided during the hearing, and it was unclear which way it will lean in its decision, expected next year. Read more.
Senate to consider sweeping opioid addiction bill
In related news, a bill to reauthorize a number of opioid addiction programs will be considered by the U.S. Senate’s health care committee next week, write Rachel Cohen and Lev Facher in an exclusive report.
If passed, the bill would be Congress’s first major action against the opioid epidemic this year, signaling the government’s commitment to keep the opioid emergency a priority. It would reauthorize programs first introduced by the 2018 SUPPORT Act that provide funding to community-based organizations working to address the addiction crisis, make permanent certain provisions that increased access to medications, and expand access to treatment for pregnant women, and incarcerated people. But even if the bill passes the committee and the full Senate, its fate remains unclear. Read more.
Patients report rampant discrimination in health care
For many people of color, health care is a minefield of discrimination and racism, according to a nationally representative survey of 6,000 people published today by the Kaiser Family Foundation. Nearly one in five Black adults and more than one in 10 Hispanic and Native people reported being mistreated in health care settings, and the experience was most common among Black women. People of color also said they expect to be mistreated and that ahead of a medical visit they pay more attention to their appearance to try and avoid discrimination.
Other expressions of discrimination, such as providers assuming something about patients without asking or blaming them for their conditions, were encountered by one in four Black patients, 20% of Native Americans, and 15% of Hispanics.
Those who could access care from providers who shared their racial background fared better. However, there still aren’t enough diverse health care providers, and less than half of patients of color reported seeing a provider who shared their background in the previous three years.
The pros and cons of mRNA flu shots
The world needs effective flu shots, and mRNA vaccines would seem to be the ideal candidate to shake up the flu vaccine market. They are quick to develop, and their first case study — Covid-19 — made history. But while there would be benefits in applying mRNA technology to influenza vaccines, there would be challenges, too, experts told Helen Branswell.
A flu mRNA vaccine could allow for a much more rapid immunization response in the event of a flu pandemic. But potential obstacles include public hesitation toward mRNA vaccines, concerns about side effects and costs, and questions about the wisdom of combining Covid-19 and flu vaccines. Plus, using mRNA technology only to produce vaccines that target seasonal flu might just be a tremendous waste of potential. Read more.
Most patients can’t afford to pay medical bills right away
Only a small minority of patients, less than 30%, pay their medical bills immediately and in full, according to a survey by AccessOne, a digital patient payments platform. In the overwhelming majority of cases, the survey found, people postpone paying medical bills because they can’t afford to cover them in full, and only a small minority (less than 5%) do so despite having sufficient funds.
This inability to cover health expenses means that a significant portion of patients, particularly among the younger generations, put off getting health care: One in three Gen Zers and Millennials, and one in four Gen Xers, report delaying a screening appointment to save money.
Understanding autism at the molecular level
Researchers have known what genes are connected to autism for over a decade. New research shows how the proteins that are encoded by genes linked with autism connect with one another and form patterns, and how mutations of the genes end up breaking or modifying such interactions.
The study, hosted on the open-access preprint server bioRxiv, has not yet been peer-reviewed. Researchers used technology such as AI protein mapping and mini-brain modeling to gain understanding of the molecular mechanisms affected by gene mutations. They say this presents an opportunity to identify new treatment targets for autism, as well as other diseases with mechanisms that could be studied through the same methodology.
“This is a proof of principle,” said Nevan Krogan, director of the Quantitative Biosciences Institute at the University of California San Francisco and a lead author of the research, told STAT. “But the sky’s the limit now as we turn this loose across many disease areas.”
What we’re reading
• Doctors on (video) call: Rural medics get long-distance help in treating man gored by bison, KFF News
• A well-meaning FDA policy is a threat to pediatric cancer treatment, STAT
• Brain implants helped five people toward recovery after traumatic injuries, New York Times
• Cancer drug shortages won’t get better under Biden’s latest plan, STAT
• Using keratin treatments or hair-straightening creams? Research suggests potential cancer risk, Wall Street Journal
• New abortion restrictions pose a serious threat to fetal surgery, STAT