美国国家公共电台 NPR Kentucky Lawmakers Limit Black Lung Claims Reviews Despite Epidemic

 

KORVA COLEMAN, HOST:

We've been covering a surge in black lung cases across Appalachia. That's the disease that destroys the lungs of coal miners like Mackie Branham.

MACKIE BRANHAM: I'm in bad shape, man. I mean, I can no longer provide for my family. And I can't get out and do nothing around the house like I normally would. It tires your nerves up.

COLEMAN: NPR's Howard Berkes has been looking at a new Kentucky law that critics say will lead to fewer sick miners getting the state benefits that they need. Hi, Howard.

HOWARD BERKES, BYLINE¹: Hi, Korva.

COLEMAN: Howard, what's in this new Kentucky law?

BERKES: This is a change in Kentucky workers' compensation law, which gives disabled coal miners who are suffering from black lung - that's the disease that results from inhaling² coal dust. It gives them medical care, and it gives them money to live on. Now, they have to prove that they have the disease and that it disabled them. And they do that primarily with X-rays of their lungs. Before the change in the law, any physician with a special federal certification could read those X-rays and decide whether the lungs were damaged by this disease. The new law says that only pulmonologists can now do that. And there are only six pulmonologists in the state who are certified³ to read black lung X-rays. And get this. Four of them have a history of working for coal companies.

COLEMAN: If most of these pulmonologists have worked for coal companies, Howard, what does this mean for miners trying to get benefits?

BERKES: Well, you have to understand that coal companies or their workers' comp insurance carriers have to pay for the black lung benefits that miners receive. And the coal companies or their carriers typically challenge any positive X-ray readings the coal miners might have as part of their claims. So we're talking millions of dollars a year that they have to pay out. And the epidemic⁴ of advanced disease that NPR has documented suggests the claims and the costs are likely to increase perhaps significantly. So if pulmonologists alone are judging the diagnostic X-rays, and most of them have a history of working for coal companies, there's a concern that fewer miners will actually qualify even when they should.

COLEMAN: So the law bans radiologists from conducting these X-ray diagnoses. What difference will that make to somebody like Mackie Branham who we heard from earlier?

BERKES: It removes radiologists like Dr. Brandon Crum who diagnosed Mackie Branham and who also first raised the alarm about this epidemic of advanced disease back in 2016. Now, Crum was featured in both NPR reporting about this and in a study conducted by federal epidemiologists that confirmed his diagnoses at his Kentucky clinic. Other radiologists with extensive black lung experience are also affected⁵. And, you know, this is what radiologists do. This is their profession, reading X-rays and other images. And some have read thousands over the years specifically as part of black lung claims. I found a report back in 1999 that showed that radiologists actually did better than pulmonologists in passing the federal exams that are required for them to become certified.

COLEMAN: And the people behind this change - why did they support it?

BERKES: The Republican lawmaker who sponsored the change, Representative Adam Koenig, said there had been wildly different diagnosis⁶ rates in the state. He said that one X-ray reader found black lung 40 percent of the time, while another had a rate of 90 percent. So he said he's just trying to standardize⁷ this process. But when I asked him why he was leaving out radiologists and leaving it to just these pulmonologists who mostly work on behalf of coal companies, he told me he relied on the expertise⁸ of those who understand the issue - the industry, coal companies and attorneys.

COLEMAN: What about other coal-mining states? Are you hearing anything about similar moves elsewhere?

BERKES: There is some concern already among advocates for coal miners in West Virginia that lawmakers there are considering the same thing. And there's now discussion among black lung activists⁹ about mobilizing opposition¹⁰. The Kentucky move caught them by surprise.

COLEMAN: Thank you, Howard.

BERKES: You're welcome, Korva.

COLEMAN: NPR's Howard Berkes has an ongoing¹¹ investigation¹² of the epidemic of advanced black lung disease.

(SOUNDBITE OF DANIJEL ZAMBO'S "COMING HOME")

1 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

2 inhaling   

v.吸入( inhale的现在分词 )

参考例句：

• He was treated for the effects of inhaling smoke. 他因吸入烟尘而接受治疗。 来自辞典例句
• The long-term effects of inhaling contaminated air is unknown. 长期吸入被污染空气的影响还无从知晓。 来自互联网

3 certified   

a.经证明合格的；具有证明文件的

参考例句：

• Doctors certified him as insane. 医生证明他精神失常。
• The planes were certified airworthy. 飞机被证明适于航行。

4 epidemic   

n.流行病；盛行；adj.流行性的，流传极广的

参考例句：

• That kind of epidemic disease has long been stamped out.那种传染病早已绝迹。
• The authorities tried to localise the epidemic.当局试图把流行病限制在局部范围。

5 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

6 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

7 standardize   

v.使符合标准，使标准化

参考例句：

• We will extend and standardize legal services and provide effective legal aid.拓展和规范法律服务，积极开展法律援助。
• There is a drive both to standardise components and to reduce the number of models on offer.正在为实现零部件标准化和减少推出的型号数量而努力。

8 expertise   

n.专门知识(或技能等)，专长

参考例句：

• We were amazed at his expertise on the ski slopes.他斜坡滑雪的技能使我们赞叹不已。
• You really have the technical expertise in a new breakthrough.让你真正在专业技术上有一个全新的突破。

9 activists   

n.（政治活动的）积极分子，活动家( activist的名词复数 )

参考例句：

• His research work was attacked by animal rights activists . 他的研究受到了动物权益维护者的抨击。
• Party activists with lower middle class pedigrees are numerous. 党的激进分子中有很多出身于中产阶级下层。 来自《简明英汉词典》

10 opposition   

n.反对，敌对

参考例句：

• The party leader is facing opposition in his own backyard.该党领袖在自己的党內遇到了反对。
• The police tried to break down the prisoner's opposition.警察设法制住了那个囚犯的反抗。

11 ongoing   

adj.进行中的，前进的

参考例句：

• The problem is ongoing.这个问题尚未解决。
• The issues raised in the report relate directly to Age Concern's ongoing work in this area.报告中提出的问题与“关心老人”组织在这方面正在做的工作有直接的关系。

12 investigation   

n.调查，调查研究

参考例句：

• In an investigation,a new fact became known, which told against him.在调查中新发现了一件对他不利的事实。
• He drew the conclusion by building on his own investigation.他根据自己的调查研究作出结论。