On Monday, the New York Times reported on the controversy surrounding Intuitive Surgical Inc.’s “daVinci” robotic surgery system — a product that allows doctors to “conduct” surgeries remotely on a console while robotic arms scale and translate their movements onto the actual patient. While high-tech systems like this are supposed to make procedures safer and more efficient, the daVinci lawsuit — which centers on a patient who eventually died from complications arising from the system’s use — reveals that a combination of factors, such as inadequate product testing and aggressive marketing strategies driven by profits, often undermine that goal.

That’s a frustrating reality for health care reform advocates on the lookout for effective methods of cutting national health expenditures while improving patient care. Although innovation in health care technology had undoubtedly improved lives and made care more efficient in the aggregate, as demonstrated through breakthroughs like vaccines and birth control, it has also accounted for at least half of the increase in health care spending in the last 70 years. While that may sound counter-intuitive at first, a quick dive into America’s health care culture shows why it’s not — and why innovations like “robot doctors” aren’t actually lowering health care costs:

1. It’s almost impossible to tell how much various health care technologies actually cost.

One of the most persistent problems in the American medical industry is rampant health care price opacity. Time Magazine’s recent investigative look into Americans’ sky-high medical bills revealed what many already suspected — that the prices of various medical products and services are essentially arbitrary, fluctuating wildly from one hospital chain to another and even more wildly between different geographic regions.

Since there isn’t an easily-accessible national database of medical devices and their prices, manufacturers can pitch their products at varying rates to hospitals and jack up prices with relative impunity. Those inflated costs are then passed on to consumers by providers looking to recoup their money — and since patients tend to trust their doctors and not know much about the intricacies of health care device markets, they don’t ask too many questions when they’re left to pick up an enormous, generally non-itemized tab at the end of a hospital stay that gives them no information about why they’re being charged what they are. Thus, price gouging and a general lack of perfect information in health care allows expensive consumption to continue unchecked.

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Adding to the extensive body of evidence that participating in Obamacare’s optional Medicaid expansion is both smart fiscal policy and the right move for securing poor Americans’ health care, a new Robert Wood Johnson Foundation and Urban Institute study concludes that states refusing to expand Medicaid will leave over 200,000 low-income, uninsured veterans and two-thirds of uninsured veterans’ spouses without access to affordable health coverage.

According to the report, out of America’s 1.3 million uninsured veterans, 40 percent could qualify for expanded Medicaid benefits under Obamacare, but “of the half-million uninsured veterans who would be potentially Medicaid eligible under the ACA, three-quarters—414,000 people—have incomes below 100 percent of FPL and would not qualify for exchange subsidies if their state does not expand Medicaid. Likewise, two-thirds of veterans’ spouses who could qualify for expanded Medicaid under the ACA would not be eligible for exchange subsidies should their state not expand Medicaid.”

That’s bad news considering that the majority of those veterans live in states whose governors have either chosen not to expand Medicaid or have not yet decided whether to expand. That presents a massive burden for veterans — and veterans’ families — who don’t have health insurance, pricing them out of the medical system and forcing them to forgo or delay care due to its associated costs.

And this study doesn’t even take into account the tens of thousands of veterans who have yet to return home from the waning Afghanistan war. Those veterans are mostly young Americans who will be forced to confront the widespread economic inequality, record homelessness, and unprecedented levels of PTSD and suicide that are plaguing veterans of the Iraq and Afghan wars.

On Tuesday afternoon, North Dakota Gov. Jack Dalrymple (R) signed into law three different abortion restrictions — HB 1305, HB 1456, and SB 2305 — that women’s health advocates say will effectively ban abortion in the state. The extreme legislation that has received the most media attention is HB 1456, an unconstitutional “fetal heartbeat” ban that would outlaw abortions after just six weeks of pregnancy, before many women even realize they’re pregnant. But when it comes to the new laws’ concrete effect on the lives of women in North Dakota, a lesser-known piece of legislation may actually pose an even bigger threat to reproductive rights.

North Dakota women will feel the immediate impact of SB 2305, which indirectly targets abortion access by over-regulating abortion providers — a popular anti-choice tactic known as the Targeted Regulation of Abortion Providers, or TRAP. Abortion opponents push TRAP laws with the ultimate goal of forcing abortion clinics to close their doors.

TRAP laws are cleverly framed in terms of ensuring women’s safety, but they’re actually incredibly effective methods of cutting off access to reproductive care at health clinics. That’s why Tammi Kromenaker, the director of North Dakota’s last remaining abortion clinic, told RH Reality Check that SB 2305 could actually represent the most serious threat to women’s abortion services in the state:

“We definitely see the TRAP bill as the one that will end abortion in the state,” Tammi Kromenaker, the director of Red River Women’s Clinic (RRWC), told RH Reality Check. RRWC is the only abortion clinic in North Dakota. “The other bills aren’t really a threat right now, but this one could close us.” [...]

These bills have drawn attention away from the true threat to RRWC: Under the new TRAP bill, abortion providers would be forced to obtain hospital admitting privileges. But at least one of the two local hospitals won’t offer those privileges to the clinic — because the quality of care at RRWC is so high that the clinic doesn’t need them.

Lawmakers proposed the bill under the guise of “women’s safety,” but Kromenaker points out that her clinic’s safety record is actually better than the average clinic safety records, showing that the “need” for the bill was completely fabricated. “This bill is intended to impose an impossible to meet requirement,” she said. “There is no other goal but to shut us down.”

North Dakota’s new six-week ban will likely be tied up in court for going much too far to undermine the constitutional protections in Roe v. Wade, which guarantees the right to first-trimester abortion services. And an even more radical “personhood” amendment, which could ban all abortions altogether if voters approve it on the 2014 November ballot, will face similar legal challenges if it becomes law. On the other hand, SB 2305 could force the Red River Women’s Clinic to close its doors relatively quickly — just like similar legislation has done to health clinics in other states.
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On Tuesday, North Dakota Governor Jack Dalrymple (R) officially signed into law three of the most radical anti-abortion bills in the nation. It will now be illegal for women in North Dakota to get an abortion after six weeks of pregnancy, while the only abortion provider in the state will likely be forced to shut down entirely. The governor also signed a law specifically forcing women whose fetuses have genetic defects to carry them to term.

Dalrymple signed the bills even after protests erupted all over the state yesterday to stand against the extreme anti-choice restrictions. Republican lawmakers broke from their party to speak out against the bills, warning they go too far. While testifying in front of the North Dakota legislature, one doctor warned that these new restrictions would force women to seek out the dangerous, backroom abortions that were common in the pre-Roe era.

North Dakota now leads the charge in state-level attacks against women’s rights; their new “fetal heartbeat” ban surpasses even Arkansas’ 12-week ban. The new restrictions also expose the state to costly legal battles, as the laws stand in direct opposition to the U.S. Supreme Court’s iconic ruling on Roe v. Wade.

Dalrymple will also consider signing a widely debunked “fetal pain” bill passed by the legislature.

Hundreds of supporters are rallying in front of the Supreme Court as the Justices are in the midst of hearing two landmark cases for LGBT equality this week. There are many cases to be made against marriage discrimination — not least of which is the fact that it’s unconstitutional. On top of that, however, mounting scientific evidence also suggests that eliminating discriminatory practices against LGBT individuals will have significant health benefits for a community that has traditionally been vulnerable to health disparities.

Here are three ways that promoting policies that ensure LGBT equality will improve our nation’s health:

1. The children of LGBT parents will grow up healthier. Just last week, the American Academy of Pediatrics formally endorsed marriage equality, citing the significant benefits in store for the children who grow up with same-sex parents. According to the group, those children will be able to take advantage of the “social and legal status social and legal status that civil marriage conveys to their parents.” Ultimately, it’s in the best interests of children for them to grow up in families that are acknowledged to be just as equal as any other family — rather than imparting harmful messages to kids that their parents somehow aren’t good enough. During this morning’s oral argument over California’s ban on same-sex marriage, Justice Anthony Kennedy spoke to this issue, noting that children of same-sex parents “want their parents to have full recognition and status” and the “voice of those children” is important.

2. LGBT couples will be able to more easily able to access health benefits. Fortunately, Obamacare will prevent insurance companies from discriminating against Americans based on gender identity or sexual orientation — but that still doesn’t mean LGBT Americans are always able to access the health care they need. The Defense of Marriage Act has continued to prevent same-sex couples from being able to enjoy all of the legal protections that other Americans can access through their spouses, including health insurance. Without access to those benefits, some LGBT individuals are forced to either purchase costly insurance plans on the individual marketplace or simply go without health care altogether. Compared to heterosexual people, LGBT individuals are less likely to have health benefits, less likely to seek medical treatment, and more likely to delay getting essential prescription medications.

3. The decreased societal stigma will benefit LGBT individuals’ mental health. In addition to the American Academy of Pediatrics, several other major medical organizations — including the American Psychological Association, the American Medial Association, the American Psychiatric Association, and the National Association of Social Workers — have all come out in support of marriage equality because of the significant mental health benefits it will afford to LGBT Americans. Significant research has documented the toll that discrimination takes on mental health, as well as the positive effects of LGBT individuals being able to come out in a supportive society. The harassment, victimization, and stigmatization of the LGBT community all contribute to the negative psychological effects of discrimination — but advancing equitable policies could help reverse some of that damage.

Backyard chickens raised for eggs and meat have been linked to an outbreak of salmonella, according to a recent story published by NPR. But though the outbreak was the largest ever to stem from contact with live poultry, it isn’t reason for people to abandon their outdoor flocks out of fear of illness.

The story cited a news brief from the Center for Disease Control and Prevention, which reported that between March 1 and September 24 last year, 195 people in 27 different states were infected with strains of salmonella, and 79 percent of them had been in contact with live poultry in the week before they became ill. But the story doesn’t note that the number pales in comparison to salmonella outbreaks linked to factory-farmed eggs and poultry. In one CDC study, the agency estimates there were more than 182,000 cases of egg-caused salmonella in the U.S. — including 70 deaths — in 2000. In 2010, more than 1,900 people contracted salmonella in an outbreak linked to Iowa egg farms that produced more than 2.3 million dozen eggs a week. And just last month, 124 people were sickened with salmonella in an outbreak linked to Foster Farms chicken.

These high numbers of salmonella cases from eggs and poultry are linked to the effects of factory farming. Chickens raised for meat are crammed tightly into warehouses that hold as many as 20,000 chickens, while the chickens raised for eggs live in sheds that can hold 100,000 birds and are often packed in battery cages with five to 10 other birds. Factory farms often contain huge amounts of feces and fecal dust produced by the birds, along with rat droppings and flies, and certain strains of salmonella can pass to the chicken if their food comes in contact with the fecal matter. In order to try to stem off the flow of disease within their flocks, farmers regularly feed the poultry antibiotics, which can lead to antibiotic-resistant strains of salmonella: in 2011, 107 people were sickened and one killed from an antibiotic-resistant strain of salmonella in turkey.

Raising backyard chickens, without the help of antibiotics, provides no risk of developing antibiotic-resistant strains of disease, and is also a way of avoiding the health risks and cruelty associated with factory farms. The practice could decrease the risk of egg-bourne salmonella: one study found cage-free poultry facilities had about 40 percent less risk of harboring salmonella. Eggs from chickens allowed to eat grass and bugs can be healthier too, containing a third less cholesterol, twice as much omega-3 fatty acids and seven times more beta-carotene.

The NPR article states the outbreak from live poultry was traced back to a single hatchery in Ohio, and quotes the CDC in saying the best way to reduce risk of salmonella through live poultry contact is to wash your hands and clean equipment used to raise poultry. There are risks involved with raising animals for food — and backyard chickens are no exception — but in this case, the benefits of home-raised eggs outweigh any the risk of disease.

According to a recent New York City Health Department analysis of city preteens’ mental health, over 145,000 children between the ages of six and 12 suffer from mental illness or other emotional problems — constituting one in five NYC children, the New York Post reports.

The report also found that city preteens’ mental health demographics approximately tracked national trends, with ADHD being the most commonly diagnosed mental illness, young boys much more likely to be diagnosed with a problem than young girls, and adverse physical effects such as sleep deprivation affecting kids with a behavioral disorder. But the report’s most disturbing findings have to do with these children’s access to appropriate care:

The study pointed to lapses in treatment. Only two-thirds of kids with a mental-disorder diagnosis received medical help in the prior year, including 36 percent who received medication. Only 17 percent of kids whose parents identified them as having behavioral problems got assistance. [...]

The Health Department insisted the city rates were in line with national figures. The department also said it offers extensive mental services through its Family Resource Centers and public-school clinics.

It encourages families to call the 24-hour hot line LifeNet (1-800-543-3638) to connect to services.

“Over 400 schools offer mental-health services, either as part of school-based health centers or via dedicated mental-health clinics,” said a Health Department spokesman, Sam Miller.

To be fair to the city, New York actually has a fairly robust public mental health system. A 2003 study finds that unmet mental health care needs for New York children and their families was almost eight percentage points lower than the national average. Still, as the paltry numbers in the city’s own analysis demonstrate, there’s still a long way to go — particularly since mental health problems that take root in youth tend to do long-lasting damage to kids’ mental and physical health.

The findings suggest that schools — which are children’s primary access points to mental health care — have to do a better job at actually utilizing those resources by identifying mental and behavioral problems in kids, and engage with parents who might be dissuaded by the societal stigma surrounding mental health care. Less than 20 percent of parents in New York City who suspect their child to have behavioral health issues decide to pursue care.