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Adam W Gaffney Profile picture
@awgaffney
Aug 24, 2021 • 7 tweets • 3 min read • Read on X
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It first seemed like ivermectin was one more low-evidence-based drug, albeit with a curious degree of politicized enthusiasm. It is far worse. Its evangelists appeared to have convinced some, perhaps many, that it is a substitute for vaccination.

washingtonpost.com/nation/2021/08… Image
Pierre Kory, the most prominent physician backer and head of the ivermectin enthusiast group FLCCC, has been cagey about this at times, but here he is posting a slide "Pfizer v. Ivermectin" suggesting superiority of ivermectin vs. vaccine in Covid prevention. Image
However, even worse is that the FLCCC Alliances' COVID-19 "prevention" protocol includes ivermectin (as well as vitamins, mouthwash, etc.) but ... no mention of vaccination. Maybe it was just an innocent oversight? Hmmm...

covid19criticalcare.com/wp-content/upl… Image
It is also notable that the FLCCC Alliances' Long Covid treatment protocol contends that Long Covid can be caused both by Covid-19 and ... Covid-19 vaccination. ("likely due to monocyte activation by the spike protein from the vaccine", they assert.)

covid19criticalcare.com/covid-19-proto… Image
Their Long Covid treatment protocol in turn calls for yet more ivermectin, "mast cell stabilizers", steroids, "monocyte repolarization therapy", and more.

They claim this protocol also works for the type of Long Covid they allege is caused by vaccination
covid19criticalcare.com/covid-19-proto… Image
(None of this is evidence-based).

Pierre Kory also made a claim about ivermectin being effective for what he called "post vaccine inflammatory syndromes" when he appeared on Joe Rogan's podcast with Bret Weinstein.
Ivermectin evangelists are delivering an effectively anti-vaccination message whatever they claim.

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More from @awgaffney

Adam W Gaffney Profile picture
Dec 19, 2024
Life expectancy figures are out for 2023.

As expected, they show further rebound.

Life expectancy now approaching (but still below) pre-pandemic level

78.4 in 2023
77.5 in 2022
78.8 in 2019

A few observations. Image
(1) This is exactly as expected because, fortunately, cases of severe COVID fell sharply after 2022 — very evident from death certificate data (and certainly observable for those of us in the ICU).

This doesn't mean all is well with US health however — far from it Image
(2) The years before the pandemic were grim, with plateauing, sometimes dropping life expectancy — a departure from 50 years of progress (progress that is the norm in modernity outside of epidemics & war). Image
Read 8 tweets
Adam W Gaffney Profile picture
Dec 18, 2024
There's growing convergence of opinion that "moral hazard"-based healthcare policies (i.e. skin-in-the game copays & deductibles) are harmful or at least unnecessary, including from some of the nation's leading health economists.

This is good, but also begs a question:
Why did it take so long? Many nations built healthcare systems premised on providing care free (or nearly so) at point of use generations ago. Ted Kennedy's first single-payer bill from early 1970s eschewed cost-sharing, as did PNHP's single-payer proposal dating from late 1980s
From his experience nearly losing his leg as a child, Tommy Douglas said: "I came to believe that health services ought not to have a price-tag on them, and that people should be able to get whatever health services they required irrespective of their individual capacity to pay." Image
Read 4 tweets
Adam W Gaffney Profile picture
Dec 12, 2024
In wake of last week's dustup over Anthem's pullback from its proposed anesthesia policy, I have a piece today at @MSNBC that responds to articles by @EricLevitz & @Noahpinion, & comments by @mattyglesias & @dylanmatt, & the question: who is to blame for our healthcare mess? Image
The above have argued that private insurance is not the real problem — the problem is those who provide healthcare. They contend the primary savings from Medicare for All-type system is not via reduced insurer waste, but lower hospital funding & clinician reimbursement.
They are factually wrong. Many studies have been done on this which they ignore. Most robust is from CBO (our detailed analysis of it is below), which found that major savings IS from reduced insurer administrative overhead — $400 billion+ a year!

healthaffairs.org/content/forefr…
Read 15 tweets
Adam W Gaffney Profile picture
Dec 5, 2024
It is true that there is a shortage of doctors in the US — primary care doctors. We have far fewer that of other wealthy nations as seen below.

However, we have similar to higher numbers of specialists — much more than France or Canada but fewer than outlier Germany. Image
This often goes unstated, I believe, because it undercuts the idea that "supply side" solutions would bring US healthcare costs in line with other nations, which is not true. We do need a PCP:specialist physician rebalancing. But the interesting thing is that increasing supply...
... in healthcare will tend to increase society-wide costs, not reduce them. That is not necessarily a bad thing if you are trying to meet unmeet needs! But building and staffing more hospitals and beds is unlikely to reduce total resources spent on hospitals.
Read 4 tweets
Adam W Gaffney Profile picture
Dec 5, 2024
This is incorrect -- the Congressional Budget Office's Medicare for All cost study projected **$400 billion** in savings annually from reduced insurance overhead.

It projected total provider payments falling by much less, or going up by much more, depending on assumptions. Image
And that doesn't account for provider-side administrative savings: Canadian hospitals spend half what US hospitals do on administrative **as a share of total revenue**

acpjournals.org/doi/10.7326/M1…
I'm not suggesting that this is the intent of the OP, but in US context it really often feels like these claims are designed to turn healthcare workers against Medicare for All (& deflect attention from the primary dysfunction of a broken, fragmented private insurance system).
Read 4 tweets
Adam W Gaffney Profile picture
Nov 16, 2024
Here is the thing about RFK Jr.

Even if you ignore his crank beliefs about WiFi & vaccines & ivermectin etc etc (not that you should), he’s also not going to do anything useful about “chronic diseases”.

Take the environment, which RFK Jr. purports to care about …
… and which can drive morbidity from chronic disease (e.g. air pollution > asthma).

Well, last time around Trump shredded a 100 environmental regulations, and worsened air quality. He’s going to do the same thing again.
Take nutrition among kids. Yes, we should have more nutritious (and free) school lunches. Do you really think Trump is going to bolster federal spending to improve access to high quality school lunches? Then I have a bridge to sell you.
Read 6 tweets

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