How viable is a system of “verbal autopsy” to determine future health policy in a country where most deaths occur outside hospitals, are not attended by doctors, and are not medically certified? Meera Kay finds out more about India’s recently completed Million Deaths Study and the training of non-medical field workers to record written narratives, from families or other reliable informants in the local language, which describe the events that preceded the death.
In a country which has around 110 million smokers, some of these deaths will be smoking related. Last month an expert panel recommended a nationwide ban on e-cigarettes, arguing that their safety has not yet been established. In the meantime, tobacco companies see a market in e-cigarettes to grow and earn huge profits in.
Doug Kamerow notices a similar trend in the US, where characters on the TV show Saturday Night Live smoke e-cigarettes to look cool. Manufacturers now pay for product placement in movies, which conventional cigarette manufacturers are not allowed to do. But despite this vigorous promotion, sales seem to be going down.
Last week the Economist newspaper offered US president Barack Obama some advice on how to fix his flagship healthcare reforms, a year after their botched launch. Introduce a European “single payer” healthcare system, scrap tax breaks for employer provided health insurance, and use those savings to help cover subsidies for the poor, said its leader article.
Some savings seem to be happening already. The BMJ’s US correspondent Michael McCarthy reports that US hospitals are projected to save $5.7bn (£3.5bn; €4.5bn) in uncompensated care costs in 2014 because of the increased number of patients who have obtained health insurance through the Affordable Care Act.
David Payne is digital editor and readers’ editor, The BMJ.