Medicaid and Breast Cancer; EVs and Air Pollution
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A Good Day To Advocate for Better Healthcare
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Pollution and Health
A new study from the University of Toronto Engineering’s Department of Civil & Mineral Engineering suggests that large-scale adoption of electric vehicles (EVs) could lead to significant population-level health benefits.
The team used computer simulations to show that aggressive electrification of the U.S. vehicle fleet, coupled with an ambitious rollout of renewable electricity generation, could result in health benefits worth between US$84 billion and $188 billion by 2050.
Even scenarios with less aggressive grid de-carbonization mostly predicted health benefits running into the tens of billions of dollars. The study is published in PNAS.
CO2 is not the only thing that comes out of the tailpipe of an internal combustion vehicle. They produce many air pollutants that have a significant, quantifiable impact on public health.
The team used their previous expertise in life-cycle assessment to build computer models that simulated the impact of large-scale EV adoption in the U.S. market. They adapted their models to simulate the production of air pollutants that are common in fossil fuel combustion, such as nitrogen oxides, sulphur oxides and small particles known as PM2.5. (University of Toronto)
Let me point out that one of the team members was also an employee of ARAMCO, the Saudi Arabian Oil producer. (Hmmm).
P.S. We have an EV and solar panels at home and we are saving a small fortune. Essentially no charge for running the care and no utility bills for 6 months out of the year. No methane in our house either.
Breast Cancer + Medicaid
Medicaid expansion has been linked to improved care and increased survival rates for patients with stage III hormone receptor (HR)–negative, HER2-positive (HR–/HER+) breast cancers, according to a study published in the Journal of National Comprehensive Cancer Network.
A related study comparing direct and indirect costs of breast cancer and associated implications found the US had the highest costs compared with Canada and Western European countries.
Medicaid expansion allows adults with income up to 138% of the federal poverty level (approximately $20,780 annually for an individual and $35,630 for a family of 3) to receive Medicaid coverage.4 Most states have adopted Medicaid expansion, with only 10 states that have not. Research has found an increase in coverage, resulting in healthier and more financially secure patients with Medicaid.
The researchers evaluated the association of Medicaid expansion with receipt of guideline-concordant treatment, time to treatment initiation, and 2-year overall survival among non-elderly women with newly diagnosed HR-negative and HER2-positive breast cancer. They utilized data from the National Cancer Database, a hospital-based cancer registry in the US that is combined with the American College of Surgeons and the American Cancer Society. Participants included women between 18 and 62 years who received an HR– or HER2+ breast cancer diagnosis between 2010 and 2018.
Of the 31,401 patients with HR–/HER2+ breast cancer, there were 19,248 living in Medicaid expansion states and 12,153 women were living in nonexpansion states. Patients living in nonexpansion states had an increased likelihood of being racial or ethnic minorities (36.2% vs 32%).
Patients in nonexpansion states were more likely to be uninsured (6.4% vs 2.4%), live in lower income regions (9.5% vs 5.7%) and nonmetropolitan areas (14.5% vs 9.5%), and were not treated at academic cancer programs (29.1% vs 35%) compared with patients in expansion states. The number of uninsured patients decreased more in expansion states compared with nonexpansion states (3.2% to 1.9% vs 6.5% to 6.3%).
Following Medicaid expansion, the 2-year survival rate increased from 93.9% to 95%. The improvement was greatest among patients newly diagnosed with stage III disease, who experienced a 3.81 percentage point (ppt) increase (95% CI, 0.82-6.80). There was also a 0.58 ppt increase in the receipt of guideline-concordant treatment with Medicaid expansion (ppt, 95% CI, 0.01-1.16).
Medicaid expansion was linked to both initiation of guideline-concordant treatment for less than 60 days from diagnosis (difference in differences [DID], 2.43 ppt; 95% CI (confidence interval), 0.68-4.18), as well as less than 90 days from diagnosis (DID, 1.41 ppt; 95% CI, 0.24-2.58).
This reinforces the important role Medicaid expansion plays in ensuring that women newly diagnosed with HR-negative, HER2-positive breast cancer have equitable access to the health care services they need-especially when prognosis depends on access to treatment.
“Expanding insurance coverage to individuals with cancer can allow them to benefit from access to life-saving treatments,” concluded the study authors. (AJMC)
Read the other way denying access to care easily leads to a death sentence.
Having access to healthcare saves lives. How about if we all had access to healthcare?
ACTION
Let’s let our elected representatives know about this study. Early detection saves lives, having access to medical care allows for early detection. Expanding Medicaid is a start - a better start is Universal Healthcare. You can reach them here, https://www.usa.gov/elected-officials.
Or use RESISTBOT. On your cell phone text SIGN PQYHNC to 50409 to send this message.
“I am your constituent and I want you to know that when cancer is involved early detection and treatment make the difference between life and death.
A recent study found that in states that have expanded Medicaid, more women have cancer detected and treated and their prognosis is significantly better than women in states who have not expanded Medicaid. Here is a link to that study, https://jnccn.org/view/journals/jnccn/aop/article-10.6004-jnccn.2024.7041/article-10.6004-jnccn.2024.7041.xml?rskey=iCWP5v&result=1.
What really saves lives is having access to healthcare. Even if Medicaid were expanded to the 10 states that have avoided it, there are still tens of millions of us who make too much for Medicaid and can’t afford healthcare. The real answer is HR 3421, the vastly improved Medicare for All act. I want you to actively support that and really help all your constituents. Thank you.”
BONUS ACTION
VOTE ACCORDINGLY UP AND DOWN THE BALLOT AND MAKE LYING WRONG AGAIN AGAIN!!!
RESOURCES
Find My Elected Officials
Contact State and Federal Representatives - phone and email
Healthcare Advocacy (Us) Website
Our Newsletter resources including reproductive healthcare - Healthcare Advocacy Reading List
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Disinformation Management
Cybersecurity Infrastructure Security Agency
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water RESISTBOT write up
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