Why Hard Science and Medicine Is Getting Mushy
Arthur Caplan, one of America’s top medical ethicists, is worried about pollution. Not the kind that ruins our oceans or makes it hard for us to breathe, but the kind that poses a threat to the “trustworthiness, utility, and value of science and medicine.”
Caplan, who directs the Division of Medical Ethics at NYU Langone Medical Center, wrote a blistering essay in last week’s Mayo Clinic Proceedings, saying, "The pollution of science and medicine by plagiarism, fraud, and predatory publishing is corroding the reliability of research. Yet neither the leadership nor those who rely on the truth of science and medicine are sounding the alarm loudly or moving to fix the problem with appropriate energy."
He goes on to cite three causes of publication pollution, which can undermine these areas of “hard science” that should be sacrosanct.
- The proliferation of journals that recruit authors who pay to get their articles published. Despite having substandard or no peer view, these "predatory publishers" now comprise an estimated 25 percent of all open-access journals. "Not only do they provide opportunities for the unscrupulous in academia and industry to pad their curriculum vitaes and bibliographies with bogus articles and editorial appointments, they also make it difficult for those involved in the assessment and promotion of scholars to discern value from junk," writes Dr. Caplan.
- Research misconduct, like falsifying or fabricating data or concealing serious violations. Fourteen percent of scientists report that their colleagues falsify data, and 72 percent report other questionable practices, according to one 2009 study published in PLoS One.
- Plagiarism, which, according to a 2010 Nature article was "staggering," requiring editors to spend "inordinate amounts of time" checking submissions they receive.
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Coming Soon: Deductible Relief Day!
You may be familiar with the concept of Tax Freedom Day – the date on which you have earned enough to pay all of your taxes for the year. Focusing on a different kind of financial burden, analysts at the Kaiser Family Foundation have created Deductible Relief Day – the date on which people in employer-sponsored insurance plans have spent enough on health care to meet the average annual deductible.
Average deductibles have more than tripled over the last decade, forcing people to spend more out of pocket each year. As a result, Deductible Relief Day is “getting later and later in the year,” Kaiser’s Larry Levitt said in a tweet Thursday.
Chart of the Day: Families Still Struggling
Ten years into what will soon be the longest economic expansion in U.S. history, 40% of families say they are still struggling, according to a new report from the Urban Institute. “Nearly 4 in 10 nonelderly adults reported that in 2018, their families experienced material hardship—defined as trouble paying or being unable to pay for housing, utilities, food, or medical care at some point during the year—which was not significantly different from the share reporting these difficulties for the previous year,” the report says. “Among adults in families with incomes below twice the federal poverty level (FPL), over 60 percent reported at least one type of material hardship in 2018.”
Chart of the Day: Pragmatism on a Public Option
A recent Morning Consult poll 3,073 U.S. adults who say they support Medicare for All shows that they are just as likely to back a public option that would allow Americans to buy into Medicare or Medicaid without eliminating private health insurance. “The data suggests that, in spite of the fervor for expanding health coverage, a majority of Medicare for All supporters, like all Americans, are leaning into their pragmatism in response to the current political climate — one which has left many skeptical that Capitol Hill can jolt into action on an ambitious proposal like Medicare for All quickly enough to wrangle the soaring costs of health care,” Morning Consult said.
Chart of the Day: The Explosive Growth of the EITC
The Earned Income Tax Credit, a refundable tax credit for low- to moderate-income workers, was established in 1975, with nominal claims of about $1.2 billion ($5.6 billion in 2016 dollars) in its first year. According to the Tax Policy Center, by 2016 “the total was $66.7 billion, almost 12 times larger in real terms.”
Chart of the Day: The Big Picture on Health Care Costs
“The health care services that rack up the highest out-of-pocket costs for patients aren't the same ones that cost the most to the health care system overall,” says Axios’s Caitlin Owens. That may distort our view of how the system works and how best to fix it. For example, Americans spend more out-of-pocket on dental services ($53 billion) than they do on hospital care ($34 billion), but the latter is a much larger part of national health care spending as a whole.
