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24-02-2013 | Article

The week in review, February 18–24, 2013

medwireNews: This week's stories include: how the Affordable Care Act still needs to push beyond its current goals; erectile dysfunction ads and the feasibility of industry self-regulation; the international epidemic of substandard drugs that demands worldwide action; another republican governor unable to resist the federal offer on Medicaid expansion.

No cigar

During president Reagan's administration in 1986, the Emergency Medical Treatment and Active Labor Act (EMTALA) was passed that essentially enforced emergency departments nationwide to provide an initial evaluation and basic, lifesaving treatment, regardless of inability to pay or lack of coverage.

The law set a precedent for defining a minimum standard in healthcare by acknowledging "community responsibilities" and "historic standards" - in other words, a mindfulness of the population as a whole rather than the individual. But EMTALA proved to be just a remedy that treated symptoms rather than the underlying disease of USA's healthcare.

Currently, physicians are arguing in Health Affairs that the Affordable Care Act might distract us in the same way by instilling a common belief that the healthcare reform laws are the end goal when 30 million people will actually remain uninsured.

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Out of bounds

While drug advertizing on television is strictly forbidden in the European Union, the USA permits it - though with some self-regulatory caveats. Companies that sell drugs to treat erectile dysfunction (ED), for example, must keep themselves in check by complying with regulations that are stipulated in the 2009 Families for ED Advertising Decency Act, which executive level representatives have assured that they do.

But a study in the Journal of Health Politics, Policy and Law has shown that compliance is actually lacking to a surprising degree as an overabundant proportion of ads are reaching youth while information is being conveyed in an unbalanced manner.

The potential repercussions entail giving children an inappropriate understanding of sex while failing to correctly inform consumers.

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Untrustworthy drugs

According to the International Federation of Pharmaceutical Manufacturers & Associations, counterfeit medicines pose a global public health risk that must be countered both locally and internationally.

At least 124 countries experience the selling of falsified, substandard, and counterfeit drugs within their borders, according to a report released by the Institute of Medicine (IOM). The causes and global health implications of widespread use of substandard drugs were alarming enough to convince the Food and Drug Administration to take a more global approach to the problem.

The IOM suggested numerous strategies to address the issue that hinged on removing the financial desperation and motivation to produce such drugs while bumping up regulatory systems in the production and distribution sectors.

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Caving in to expansion

During his campaign to be the governor of Florida 3 years ago, Rick Scott flaunted his strong resistance to the Obama administration's healthcare reform law. After the Supreme Court ruled that the Affordable Care Act was constitutional while Medicaid expansion was optional, Scott was one of the most adamant governors to promise their state's abstinence from accepting federal money to expand coverage for the poor.

Recently, after being promised that Medicaid coverage could be privatized, Scott caved in to the Department of Health and Human Services and decided to go along with providing over 1 million uninsured Floridians with coverage.

According to some estimates, the deal was just too good to turn down; while $ 3 billion goes out-of-pocket for the next 10 years, the state will gain $ 26 billion in federal Medicaid money.

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By Peter Sergo, medwireNews Reporter