Brainstorm Health Daily: July 28, 2017

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Okay, whose heart rate just went up?

There are few more universally terrifying images, it seems, than the sight of a dorsal fin (or worse, multiple fins) cutting a circle in the rolling surface of saltwater. The fin glides leisurely at first; then it gains speed, almost imperceptibly, as the circle’s diameter shrinks around you.

It is a fin—not a cavernous jaw. A thin, sloping triangle of cartilage poking up from the dark ocean. It is not the 2,000-pound hulk of a great white shark you see, but in some ways it is a more frightening sight—precisely because of what remains unseen.

That, if you’ll forgive this analogy, is what the so-called “Skinny Repeal” was. Skinny, of course, was the last and most cynical of the various Trumpcare resolutions that the Senate Majority Leader put forth this week—and which the full Senate voted on, and ultimately rejected, in the dead of night. This eight-page bill was the dorsal fin of legislation: It was alarming for what it didn’t show.

The Republican leadership asked its caucus to vote on provisions that remained not only unseen, but undetermined—left to the vagaries of two handfuls of negotiators, from two legislative chambers, who would have the power, essentially, to rewrite the bill any way they chose. Once out of conference, GOP lawmakers in both the House and Senate would feel all the more obligated to pass it, whatever it turned out to be.

The other potential outcome—again, unknowable, really—was that the House would pass the Senate’s Skinny as written, shoving Obamacare off the mountainside without a viable replacement plan and without the slightest hint of its effects on the health of a nation.

Whatever you think of John McCain—whether you like him or not, support his political views or reject them outright—the senior senator from Arizona—along with two other Republican Senators, Lisa Murkowski of Alaska and Susan Collins of Maine—refused to append their names to a bill they couldn’t see. The three swam up to the predator below the fin and punched it square in the nose last night.

Senator McCain, it should be noted, had long been part of the “Repeal Obamacare” chorus. He had voted to support previous efforts to kill the ACA. But last night’s roll call wasn’t about repeal-and-replace. It was a legislative feint, a big ole’ “Close your eyes and trust me.” I’m happy to say that McCain—who spoke eloquently earlier in the week about the dangers of such reckless political tactics—put his vote where his mouth is.

Finally, I was going to dedicate this last Shark Week essay to Shark Tank—posing the question: “Why don’t we have a Shark Tank for healthcare startups?” Feel free to write me with your own answers to that question.

In the meantime, Sy has a preview (below) of a terrific interview he did with Shark Tank’s Robert Herjavec—and his support for one iteration of a cancer-focused Shark Tank.

Enjoy the weekend, everyone. Sy has the news below.

DIGITAL HEALTH

A "Shark" on the importance of non-drug tech in cancer care. Medication is an indispensable part of cancer treatment. But it doesn’t necessarily encompass all of a patient's needs. I interviewed Diane Jooris, co-founder of Oncomfort and the winner of the 2016 Astellas Oncology C3 prize, and Shark Tank’s Robert Herjavec, one of the competition’s judges, on the promise that non-drug technology holds for people grappling with cancer. Oncomfort’s platform uses virtual reality to soothe children who are going through stressful medical procedures with various games and activities. Herjavec, an entrepreneur whose own mother grappled with the scourge, expounded on this kind of tech's promise. "[W]e found that when it came to obstacles outside of clinical treatment we were in search of more support,” he says. "Coordinating care for loved ones, keeping track of treatments and medication protocols - it was daunting! Beyond that, survivorship was also challenging – finding community, for example, and learning how to adjust to life after cancer wasn’t easy." Stay tuned for more from my interviews with Diane and Robert.

THE BIG PICTURE

The Senate's health care bill is dead (again). Here's what comes next. In a bit of high-stakes drama that had health reporters glued to soundless C-SPAN 2 streaming of lawmakers standing around talking well into early Friday morning, three Republican Senators—including Arizona's John McCain—put the final stake through the latest iteration of Obamacare repeal. But what's next? It's possible that any future efforts will require a process that involves Democrats and an ordinary committee process. And there are signs that (very early) bipartisan efforts may be underway.

FDA aims to make cigarettes less addictive. The Food and Drug Administration (FDA) is mulling a plan that could significantly curb the amount of tobacco in cigarettes—all the way down to "non-addictive" levels. "Because almost 90% of adult smokers started smoking before the age of 18 and nearly 2,500 youth smoke their first cigarette every day in the U.S., lowering nicotine levels could decrease the likelihood that future generations become addicted to cigarettes and allow more currently addicted smokers to quit," the agency wrote. Tobacco company stocks fell sharply on the news. (Fortune)

REQUIRED READING

Elon Musk's SpaceX Is Now More Valuable Than Snapchat, by Lucinda Shen

Samsung Dethrones Intel As World's Biggest Chip Maker, by Jonathan Vanian

Meg Whitman: I'm Not Going to Uber, by Barb Darrow

When Anthony Scaramucci Called Me and Asked a Bizarre Question About Trump, by Jen Wieczner