Uh-Oh! Building ObamaCare’s Health Exchanges Has Already Cost Double the Expected Amount

Credit: WhiteHouse.govHere’s another ominous sign for ObamaCare’s future: The Department of Health and Human Services admitted yesterday that setting up the law has cost twice as much as expected so far. And you can't really blame Republican opposition for the overrun: That’s just accounting for the cost of building exchanges in states that said they want to run them.

Here’s The Hill with the report:

The Health and Human Services Department (HHS) said in budget documents Wednesday that it expects to spend $4.4 billion by the end of this year on grants to help states set up new insurance exchanges. HHS had estimated last year that the grants would cost $2 billion.

The department also is asking Congress for another $1.5 billion to help set up federally run exchanges in states that do not establish their own.

Just because HHS is asking for the money, of course, doesn’t mean it’s going to get it. So if not, then what? The HHS has promised it will, er, do something—something!—to make it all work. But it won’t say what. At least not yet:

HHS Assistant Secretary for Financial Resources Ellen Murray punted Wednesday when asked about the consequences if Congress also denies the new request.

The department is "determined to make them work," she said of the exchanges.

A big chunk of the grant money doled out so far went to California. It has reportedly received $909 million in federal funding to build its exchange. But even with the hefty funding it's not going smoothly. The state's insurance regulators have warned that residents should expect "rate and market disruption" when the state's health insurance exchange opens. 

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Why You Should Care About The Increasing Amount Of Fraud In Scientific Research

The Washington Post reported on the equivalent of an ongoing academic thriller unfurling at Johns Hopkins earlier this week, involving a researcher who alleges he was fired in retaliation for his criticism of flawed methodology — later used in an article published in Nature, one of most prestigious research journals — and the suicide of the primary author of the research while drafting a response to that criticism.

But while the full story remains to play out — Johns Hopkins refuses to comment and Nature has been quiet besides saying they expect to release a response in the future — this seedy tale can help bring one dark underbelly of the modern research world to light: How the academic politics of retraction and the pressure to publish may have an adverse effect on the quality of modern research.

A study published last year by Proceedings of the National Academy of Sciences noted that there has been a tenfold increase in scientific articles retracted due to fraud since 1975. Of the over 2000 biomedical and life-science retracted research articles studied, 21.3 percent of them were attributed to errors while 67.4 percent were due to researcher misconduct.  The Washington Post discussed the issue with one of the study’s authors, Ferric C. Fang:

“Fang said retractions may be rising because it is simply easier to cheat in an era of digital images, which can be easily manipulated. But he said the increase is caused at least in part by the growing competition for publication and for NIH grant money.

He noted that in the 1960s, about two out of three NIH grant requests were funded; today, the success rate for applicants for research funding is about one in five. At the same time, getting work published in the most esteemed journals, such as Nature, has become a “fetish” for some scientists, Fang said.”

While public funds support a majority of basic research in the U.S., those resources have been dwindling for years and took a significant hit in the sequester. That increase in competitiveness pressures researchers to present results, undoubtedly leading to some researchers falsifying their data in order to preserve their slice of the dwindling public research pie — also known as fraud. And when fraudulent research makes it through the publication process, it becomes part of the knowledge base built upon by other researchers around the world. For every fraudulent piece of research published, many more may rely on faulty grounding for future research projects, thus intellectually contaminating research areas with incorrectly drawn conclusions and impeding future advances.

The pitfalls of fraudulent research aren’t just theoretical: In the late 1990s, a medical researcher “misrepresented or altered the medical histories of all 12 of the patients” in a much-publicized study linking childhood vaccination to autism, in what some other researchers have called “the most damaging medical hoax of the last 100 years.” Between when the study was first came out and when it was disproved and retracted, there was a notable drop in youth vaccinations — which is bad for the health of our nation’s children, and the public at large.

Yet despite the severity of the problem and the great stakes at play, there is no centralized database to track these retractions — although new resources have emerged, like Retraction Watch, a blog run by two health journalists keeping tabs on the ongoing drama.

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The Meat Industry Consumes Four Times The Amount Of Antibiotics As Sick Americans Do

The meat industry uses a considerable amount of antibiotics to fight bacteria on its livestock farms — so much so that it actually far outpaces the amount of antibiotics used to treat sick people in the country. According to FDA data compiled by Pew Charitable Trusts, the livestock industry is consuming almost four-fifths of the total amount of antibiotics used in the U.S.:

And, as Mother Jones points out, that points to a dangerous trend in the meat industry. As livestock in close quarters breed bacteria, and the industry uses more and more antibiotics during their production in order to contain those pathogens, common bacteria are developing a resistance to drugs. For example, more than 75 percent of the salmonella found on ground turkey in 2011 was resistant to at least one antibiotic used to treat it — and over half were resistant to three or more different antibiotics. Unless the meat industry changes its practices, the FDA will have a difficult time keeping up with ensuring their products are safe to consume.

And even though Americans are consuming considerably fewer antibiotics than the meat industry, antibiotic resistance isn’t just an issue among lifestock farms. Diseases that affect humans — such as whooping cough, tuberculosis, and gonorrhea — are also growing increasingly resistant to the drugs used to treat them. Since testing and marketing new antibiotics isn’t as profitable for the pharmaceutical industry as selling the drugs that are already on the market, production has lagged behind over the past few decades, and global health officials warn that an impending “antibiotic apocalypse” could make even the most common infections incurable.

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