The disease that doesn’t discriminate

The ideas and innovators shaping health care

Apr 04, 2023 View in browser   By Carmen Paun, Ben Leonard, Ruth Reader and Erin Schumaker WORLD VIEW Two lines mean joy for people undergoing treatment for infertility. | Johannes Jander/Flickr There’s a health issue that doesn’t discriminate between rich and poor: infertility. Infertility rates are comparable among regions, the World Health Organization said in a new report. Roughly 1 in 6 people experience it. Even so: Treatments — including in vitro fertilization — are much more readily available in wealthy countries. “The sheer proportion of people affected shows the need to widen access to fertility care,” said WHO director-general Tedros Adhanom Ghebreyesus. The problem: Infertility is a disease of the male or female reproductive system that results in a failure to conceive after a year or more of regular unprotected sexual intercourse. The fertility business: Some private insurance in the U.S. covers IVF, some doesn’t. Neither Medicaid nor Obamacare requires coverage, though some states do. Many Americans struggle to afford infertility treatment. By contrast, many European countries, including Belgium, Switzerland, and the U.K., cover typically between three to six cycles of assisted reproductive technology, said Gitau Mburu, fertility research scientist at the WHO. People in poor countries are worse off, spending a greater proportion of their income on fertility care compared to people in wealthier countries. High costs frequently prevent people from accessing infertility treatments or, alternatively, can catapult them into poverty. In some of the poorer countries with no subsidies, the cost patients paid was significantly higher than the average annual income in that country, according to a separate study by the WHO and the United Nations’ Special Programme of Research, Development and Research Training in Human Reproduction. Still, there's considerable variation even in the developing world: — In Zimbabwe, the cost to access care was some 450 percent higher than the annual average income. — In Sudan, it was nearly 402 percent higher, and nearly 244 percent more in Ecuador. — By contrast, patients in countries offering some support to people experiencing infertility, such as Iran, spent half of their average annual income on one round of treatment, the WHO study showed. — Argentina, Indonesia and Morocco have recently started providing infertility care as part of their publicly funded health care system, the WHO’s Mburu said.   JOIN POLITICO ON 4/5 FOR THE 2023 RECAST POWER LIST: America’s demographics and power dynamics are changing — and POLITICO is recasting how it covers the intersection of race, identity, politics and policy. Join us for a conversation on the themes of the 2023 Recast Power List that will examine America’s decision-making tables, who gets to sit at them, and the challenges that still need to be addressed. REGISTER HERE.     WELCOME TO FUTURE PULSE Eisenhower Executive Office Building, Washington, D.C. | Ben Leonard This is where we explore the ideas and innovators shaping health care. Beyond just lifting our spirits, cats and dogs may have another benefit, according to new research: preventing food allergies. A study from Japan found that fetal or infant exposure to dogs and cats seemed to reduce risk of food allergies. Tough luck for hamsters, though. Exposure to them appeared to raise the risk of nut allergies. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, your host Ben talks with David Lim, who explores the implications of the Federal Trade Commission's decision to force biotech company Illumina to unwind its acquisition of Grail, a multicancer early-detection test company. Listen to today’s Pulse Check podcast INFLUENCERS “We have a Wild West of algorithms." Michael Pencina, co-founder of the Coalition for Health AI and director of Duke AI Health The Coalition for Health AI, an alliance of major health systems and tech companies, has released a blueprint for setting artificial intelligence standards in health care. And with a little cooperation between industry and government, the coalition believes the laissez-faire environment that now exists can transform into one imbued with trust. When it comes to AI’s use in health care, the coalition’s aim is to help “define the problem and suggest solutions,” said John Halamka, president of the Mayo Clinic Platform, a coalition member. The ideal outcome: “Government will set standards for testing and monitoring,” Halamka added. “Industry will operate accredited assurance labs that will publish the results of AI validations. The result will be transparency and trustworthines.” Among other things, the blueprint calls for: — AI to be continuously monitored throughout its lifecycle to ensure transparency — Careful efforts to avoid bias in algorithms — Data security and privacy protections Why it matters: Regulators are grappling with how to regulate artificial intelligence in health care as providers use it to inform diagnoses and treatment decisions. What’s next: The coalition will hold a webinar Wednesday with Alan Mislove, a Northeastern University computer scientist who joined the White House Office of Science and Technology Policy this year as assistant director for data and democracy.   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     WASHINGTON WATCH Tester has a bill to force changes in the VA's handling of its electronic health records system. | Francis Chung/E&E News Chances are rising that Congress will order an overhaul of the Veterans Affairs Department’s troubled electronic health records program. Sen. Jon Tester (D-Mont.), chair of the Veterans’ Affairs Committee, unveiled sweeping legislation that would require the VA to revamp the program. By doing so, he joins his House counterpart, Rep. Mike Bost (R-Ill.), who’s proposed a separate bill to prevent the VA from rolling out the system at new locations before “significant improvements” are made. Why it matters: The VA’s effort to upgrade its electronic health records system is mired in problems. The rollout started in 2018 at a projected cost of $10 billion over 10 years, but a recent VA-commissioned Institute for Defense Analyses estimate put that figure at $50 billion over 28 years. The vendor, Oracle Cerner, has disputed that projection. Plus, there are safety concerns. The VA told Congress last month that six veterans may have been harmed by the system’s failure to properly account for their records. The system is live at only a few of the 171 VA medical centers, and rollouts are on pause until June. Tester has asked the VA to renegotiate its contract with Oracle Cerner before it expires in May, with discounted prices and “severe” penalties for “poor performance.” Tester’s legislation, co-sponsored by the Senate's top appropriator, Patty Murray (D-Wash.), and Sherrod Brown (D-Ohio), would mandate that the VA: — Use metrics to determine whether and how it should move forward with the system at new medical centers — Pause the rollout at new facilities until Oracle Cerner can show its system performs better than the old one or meets national standards — Craft a “Plan B” strategy in case Oracle Cerner doesn’t agree to a new contract with sufficient protections Oracle’s response: Executive Vice President Mike Sicilia told senators last month that the company has made “dramatic improvements” but acknowledged more work still needs to be done.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

To change your alert settings, please log in at https://www.politico.com/_login?base=https%3A%2F%2Fwww.politico.com/settings This email was sent to rouf@idiot.cloudns.cc by: POLITICO, LLC 1000 Wilson Blvd. Arlington, VA, 22209, USA Please click here and follow the steps to unsubscribe.