Black Lungs Cold Hearts
Much of the drama in Kentucky's legislature last week was around Senate Bill 151, an unexpected and fast-moving bill that Republicans pushed through to end pensions for new teachers, replacing the defined benefits with a 401(k) style system. But Kentucky Gov. Matt Bevin (R) also signed House Bill 2, which overhauls workers compensation in the state in a way that will make it harder for coal miners with black lung to get state benefits. The law allows only federally certified pulmonologists, not radiologists, to determine if X-rays show black lung.
The problem for coal minders, NPR reports, is that Kentucky has only six federally certified pulmonologists, "four of them routinely are hired by coal companies or their insurers" and one is semi-retired and losing his federal National Institute for Occupational Safety and Health (NIOSH) certification June 1, leaving just one doctor who generally works for coal miners rather than coal companies. The law excludes radiologist Dr. Brandon Crum, for example, who helped uncover one of the biggest clusters of complicated black lung ever documented. NPR's survey of Appalachia has counted more than 2,200 advanced black lung diagnoses since 2010.
"It is curious to me that the legislators feel that the pulmonologist is more qualified to interpret a chest radiograph than a radiologist is," Dr. Kathleen DePonte told NPR. "This is primarily what radiologists do." The lawmaker who sponsored the change, state Rep. Adam Koenig (R), said he was motivated by the disparity between pulmonologists, who tend to be conservative in their black lung diagnoses, and radiologists, who tend to diagnose the fatal disease more liberally. He told NPR that he "relied on the expertise of those who understand the issue — the industry, coal companies and attorneys," adding, "All we're doing is making sure that qualified doctors are making these determinations." You can listen to NPR's report from Sunday's Weekend Edition below. Peter Weber