McConnell urges Republican men to get vaccinated; Beshear praises him, asks other GOP leaders to join in the encouragement

McConnell speaks. (Photo by Melissa Patrick)

By Melissa Patrick
Kentucky Health News

After touring the mass-vaccination site at the University of Kentucky's Kroger Field Monday, Senate Republican Leader Mitch McConnell urged Kentuckians to get vaccinated, especially Republican men, who polls have found are some of the most reluctant to get a shot.

“I saw on some program last week that Republican men, curiously enough, might be reluctant to take the vaccine,” McConnell said, understating.

Pointing an index finger upward, he said, "I'm a Republican man, and I want to say to everyone, you need to take this vaccine. These reservations need to be put aside, because the only way I think to get, to finally put this pandemic in the rearview mirror, is with herd immunity . . . 75 percent of us need to take this vaccine.”

As McConnell spoke, only 41% of Kentuckians 16 and older had received at least one dose of a vaccine, and the state had just opened vaccinations to residents 16 and up. Gov. Andy Beshear said at his Monday briefing that would add upwards of 1.3 million more people to the official eligibility list. 

McConnell said, "So, we have a ways to go if we are gonna all really be back to normal by this summer. We still have a way to go here in Kentucky and all across America to get those shots in arms over the next few months." 

Asked why he thought there was so much vaccine hesitancy among Republican men, and if Donald Trump's presidency played a role in it, McConnell said he didn't know the reason for it. 

An NPR/PBS/Marist College poll released earlier this month found that only 20% of Republican men said they have been vaccinated, and 49% said they would refuse a vaccine if it was offered.

Asked by Kentucky Health News if he still had "total" confidence in Dr. Anthony Fauci, which he told KHN when asked likewise in mid-July, he said, "Yes, I think he's the principal person we've relied on for the last couple of years. He's become somewhat controversial, I gather, but we have to take advice from somebody. And for myself, looking at his history and background, he's the most reliable witness I've seen."

Kentucky's other senator, Republican Rand Paul, has frequently clashed with Fauci, director of the National Institute of Allergy and Infectious Diseases, and challenged his wearing of masks after vaccination.

Women outnumber men in Kentucky vaccinations by 4 to 3, Gov. Andy Beshear said at his news briefing later in the day. The report he cited does not provide information about political leanings.

Asked about this disparity among men and women, and in particular about the reluctance of Republican men to get vaccinated, Beshear praised McConnell for following public-health measures throughout the pandemic, for getting vaccinated, and for encouraging others to do so. 

"The data we see says that overall men are more hesitant than women, and Republican men are more hesitant than virtually anybody else," said Beshear." To me, I want everybody to get the protection that a vaccine provides. It protects the Republican man as much as it protects anybody else." 

Beshear stressed the value of political leaders encouraging vaccinations, and said he had sent a letter to the state's congressional delegation, asking them to do that, especially among Republicans and Republican men. All in the delegation are Republicans except Rep. John Yarmuth, D-Louisville. 

"There are some that may not listen to anybody, or there may be some who only listen to one person out there. We really need them to open their minds and open their hearts," Beshear said. "You know, to me, being vaccinated was following the science, but it was also following my faith and knowing that it can protect those around me."  

Bevin joins lawsuit that targets federal transgender rule, saying it will force health-care providers to provide 'controversial services'

By Melissa Patrick
Kentucky Health News

Gov. Matt Bevin has joined a lawsuit that challenges a federal rule guaranteeing transgender people equal treatment by insurers and medical providers.

"Not only does the rule require taxpayers to fund all treatments designed to transition to a different sex, it also forces health-care workers, including physicians, to provide controversial services," says a state news release. "Under the new rule, a physician who believes that certain treatments are not in a patient's best medical interests may be in violation of federal law."

"The Obama administration continues its attacks on the constitutional rights and religious freedoms of Kentuckians," Bevin said in the release. "It is both appalling and illegal for the federal government to force Kentucky taxpayers to foot the bill for sex-change operations."

Mara Keisling, executive director of the National Center for Transgender Equality, told Pete Williams of NBC News that the rule is intended to prevent discrimination against transgender people in getting access to all kinds of health care.

"The ACA rule does not mandate what kind of care doctors can and cannot give. It bans discrimination. It's there to make sure that transgender people can get the treatment we need without facing harassment — or worse," she said. "It simply requires that medical decisions be made based on medicine, not prejudice."

The rule falls under the nondiscrimination provisions of the Patient Protection and Affordable Care Act that offers protections against discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs or activities. The new rule expanded the definition of gender identity to mean a person's "internal sense of gender which may be male, female, neither, or a combination of male and female." The rule went into effect July 18.

The rule extends to any health program or activity that receives funding from the U.S. Department of Health and Human Services, including health insurers on the state and federal exchanges.

The lawsuit was filed Tuesday in Fort Worth by Texas, Kansas, Kentucky, Nebraska, Wisconsin, joined by the Christian Medical and Dental Association and the Franciscan Alliance. It is filed against HHS and its secretary, Sylvia Burwell.

"This is the second lawsuit Bevin has joined over transgender issues. In May, he joined 12 other states in a challenge of federal guidelines to accommodate transgender students in schools," Daniel Desrochers notes for the Lexington Herald-Leader.

"Kentucky taxpayer dollars will not fund this lawsuit," says the release, but it doesn't say who will.

Feds strengthen anti-discrimination health rules

Photo from mdxipe.wordpress.com

By Danielle Ray
Kentucky Health News

The Department of Health and Human Services issued rules Friday in an effort to ensure equality in health care for women, the disabled and people who speak English as a second language.

The new provisions protect women from discrimination not only in the health coverage they obtain but in the health services they seek from providers. They also prohibit denial of health care or health coverage based on a person's sex, including discrimination based on pregnancy, gender identity and sex stereotyping.

The rule also requires providers to take reasonable steps to provide communication access to people with limited English proficiency. In addition, it requires that providers make electronic information and newly constructed or altered facilities accessible to individuals with disabilities, including providing auxiliary aids and services.

HHS Secretary Sylvia Burwell called the rule "a key step toward realizing equity within our health care system." She said in an agency news release that it reinforces the central goal of the Patient Protection and Affordable Health Care Act, to improve access to quality health care.

The rule covers any health program or activity that receives federal funding, such as providers who accept Medicare or Medicaid; any health program that HHS administers; and federal- and state-based health insurance marketplaces and insurers that participate in them.

The new rule implements Section 1557 of the 2010 health-reform law, which is the first federal civil-rights law to prohibit discrimination based on sex in federally-funded health programs. Previously, civil rights laws enforced by the agency's civil rights office barred discrimination based only on race, color, national origin, disability, and age.

The rule does not resolve whether discrimination on the basis of an individual’s sexual orientation status alone is a form of sex discrimination under the reform law. However, the provisions leave room for the agency's civil-rights office to evaluate complaints that allege sex discrimination related to a person’s sexual orientation to determine if they can be considered sex stereotyping, which the rule prohibits. In cases where religious freedom would be violated, health-care providers are not required to follow the regulation.

A summary of the new rule can be accessed here.

Female legislator files bill to put restrictions on erectile-dysfunction medications to make a point about men pushing abortion bills

Rep. Mary Lou Marzian

Fed up with a string of anti-abortion bills backed by religious conservatives, Democratic state Rep. Mary Lou Marzian of Louisville has filed a bill that would require men seeking medication to treat erectile dysfunction to have two office visits with a doctor -- and limit such prescriptions to married men who swear on a Bible that they will use the drug only for sex with their spouse, who would have to consent to the prescription.

“I just thought my 80 male colleagues in the House might like to consider what it feels like when legislators get between them and their physicians,” Marzian told John Cheves of the Lexington Herald-Leader.

“I’m just sick of them,” she told Joe Sonka of Insider Louisville. “It’s just to make a point. Should we have a bunch of politicians untrained in health care telling women what to do? So I thought I’d just tell them what to do.”

Sonka notes that Gov. Matt Bevin has already signed a bill requiring a woman seeking an abortion to have a face-to-face consultation with a doctor, and the Senate is moving a bill that would require a trans-vaginal ultrasound before an abortion.

Marzian's counter-measure is House Bill 396. "Much of the bill’s sentiment, and some of its precise language, mirrors the anti-abortion bills," Cheves notes. "That’s not a coincidence," said Marzian, a retired Louisville nurse. Cheves notes that almost half of House members are 60 or older.

Marzian told Sonka she may file the bill's language as an amendment to the Senate bill and other anti-abortion measures “to demonstrate how ridiculous it is for elected government officials to be meddling in private health care decisions. … they’re so obsessed with uteruses and ovaries and women’s health, but not concerned about the 9 percent cut to mental health services” proposed by Bevin as part of budget reductions for most state agencies.

Body-mass index fails to identify some as obese, mainly women

Many Americans, particularly women, are actually obese though they think their weight is healthy because of weaknesses in the body-mass index formula.

A study comparing people's BMIs to a blood test and body scan found that the height-to-weight ratio formula was wrong in half of women and 1 in 4 men.

"It's commonly acknowledged that the BMI can produce inaccurate results for athletes and others with a lot of muscle mass,"  Misti Crane reports for The Columbus Dispatch . "But this research illuminates a problem on the other end of the scale: people who think they're fine but are carrying a lot of fat and little muscle."

"Particularly women, as they age, their muscles become inserted with fat, even though they stay thin and beautiful in a dress," said Dr. Eric Braverman, a New York physician who co-wrote the study.

Braverman and co-author New York State Health Commissioner Nirav R. Shah propose that the BMI cutoff for determining obesity should be 24 for women and 28 for men. Now, it's 30 for both sexes. "They also say that doctors should consider blood tests to measure leptin, a hormone that goes up with increased body fat, and DXA scans. The scans are commonly used to assess bone density but can be used to analyze body fat," Crane reports.

Though experts know the BMI calculation is not perfect, there is one major advantage: It's free. "You have to understand that BMI is an estimate of fatness, it's not a measure of fatness. But there are very few screening-tool estimates we have that are as simple to use," said Dr. Patricia Choban, medical director of the bariatric-surgery problem at Mount Carmel West Hospital. (Read more)

Kentuckians think cancer is biggest threat to adults, but heart disease kills more men in the state

Cancer is the leading health concern identified by Kentuckians, and is the principal cause of death among women in the state, though heart disease is the main killer of Kentucky men, the Kentucky Health Issues Poll found.

Thirty-six percent of Kentucky adults identified cancer as the most important health issue for men, followed by heart disease at 31 percent, according to a news release for the Foundation for a Healthy Kentucky, which co-funded the poll. Heart disease was the leading cause of death for Kentucky men in 2009, followed closely by cancer.

Only about 7 percent of Kentuckians identified obesity as the top health issue facing Kentucky adults, but 29 percent said it was the greatest concern for children, perhaps reflecting considerable public attention to concern about child obesity. "While childhood mortality is rare, there are lifelong health implications that can be linked to struggling with obesity and diabetes at an early age," the release said.

“Even though the results suggest some confusion about our biggest health threats, there are ways to reduce Kentucky’s chronic disease risks: eat healthy foods, exercise regularly, stop smoking or don’t start,” said Dr. Susan Zepeda, CEO of the foundation, which co-sponsored the poll with the Institute for Policy Research at the University of Cincinnati. The poll interviewed a random sample of 1,677 adults, 1,469 by landline phones and 208 via cell phones. In 95 of 100 cases, the estimates are accurate within a 2.4 percent margin of error. To see the report, click here.