By Sophie Kevany for Sentient.
Broadcast version by Roz Brown for New Mexico News Connection reporting for the Sentient-Public News Service Collaboration

It's a well-known fact that factory farms rely on antibiotics to treat animals raised in cramped, unsanitary conditions. Lesser known is the rising quantity of antibiotics needed to do just that. Sales of medically important antibiotics for use in U.S. livestock farming rose over four percent in 2022, compared to a year earlier, and show an overall upward trend since 2018, risking greater human mortality from antibiotic-resistant infections.

Medically important antimicrobials - a broader term for drugs, including antibiotics, that kill microorganisms - are those considered essential for treating human disease. Globally, the livestock industry fed an estimated 99,502 metric tons of antimicrobials in 2020 to the billions of cattle, sheep, chicken and pigs raised for food that year.

Such widespread antimicrobial use has been linked to the development of resistant bacteria and other organisms like fungi. Infection from antimicrobial-resistant organisms is described as a "growing crisis" by the American Public Health Association and other health professionals and scientists.

People and animals infected by resistant organisms are harder to cure. In the U.S., the Centers for Disease Control estimates there are over 2.8 million antibiotic-resistant infections every year. Of those, over 35,000 people eventually die. Globally, one study found there were an estimated 4.95 million deaths associated with bacterial antimicrobial resistance.

Factory Farms Depend on Antibiotics to Raise Billions of Animals

The Food and Drug Administration data show sales of medically important antimicrobials approved for use in farm animals rose 4.3 percent to 6.25 million kilograms in 2022. The 2022 figure is a significant decrease on the 8.36 million kilograms sold in 2016, the earliest year shown in the data. But the 2022 figure is higher than all other years since 2016, indicating a more recent trend in the wrong direction.

Thomas van Boeckel, an expert in global antimicrobial usage and resistance in farm animals, fish and humans, says the upward swing indicates that "unlike some European and Asian countries ... the U.S. is clearly not on a trend that shows its commitment to sustainably reduce antimicrobial use in animals."

The data, he adds, shows the problem is "mostly a pig and cattle issue" and reveals "a dependence" by the livestock sector on antibiotics that has "potential consequences on the continued development of resistance."

Prior to 2016, the use of medically important drugs for livestock was even higher, says Steven Roach of the Food Animal Concerns Trust. To control the problem, federal rules were tightened in 2017 to prevent farmers using the drugs for growth promotion.

By species, the administration's data shows 2022 sales of medically important antibiotics for cattle were up 4.3 percent to 2.57 million kilograms, higher than any other year since 2016. For pigs, sales rose almost 5 percent to 2.66 million kilograms, again higher than any year since 2016.

Treating Healthy Animals Has Deadly Consequences for Humans

Farmers use antimicrobials in three ways, Roach says. "Treating a sick animal, which everyone supports. Treating a particular group of animals, for example if there is a risk of infection from one sick animal, which we also support," he says.

The third use, which Roach opposes and is prohibited in Europe, is treating healthy animals to prevent disease, a practice known as prophylaxis. For example, Roach says, months of preventative treatment of cattle can happen in feedlots where the animal's weight promoting, high energy diet produces a bacteria that can infect their livers. To prevent liver problems, medically important antimicrobials called macrolides are used, Roach says.

Most antimicrobials are fed to livestock via their feed and water. Research has linked the addition of antimicrobials to water with the faster breeding and spread of resistant bacteria between animals and feedlot workers.

The FDA data, Roach added, does not "tell us the percentages of how much of each antimicrobial is used for which category," making it hard to know the level of preventative use.

Not only does Roach agree that the U.S. livestock sector is falling behind other countries in using more, not less, medically important antimicrobials, he says the government appears uninterested in the problem.

"We can't even get anyone in the U.S. government to say that there is a need to reduce medically important antimicrobials in food animals," he says, blaming livestock industry lobbying for the current predicament.

Roach hopes the FDA "will realize it has to act and follow the EU and prohibit the use of [the drugs] for disease prevention." He adds, "the FDA could also set a public health goal to reduce their use, say by 50 percent by a certain year, which is what other countries have done."

Absent government action to prevent prophylactic use of the drugs, Roach says the most successful route to reducing their use in livestock is consumer pressure. "We have had good luck getting big meat buyers to put pressure on companies. The good news is in chicken, it is going down and part of that was pressure on the companies [to reduce their use of medically important antimicrobials] and a choice by Tyson and Perdue to quit using them."

Some companies are avoiding antibiotics altogether. "[Our] family farmers and ranchers prove every day that routine antibiotic use is not necessary when animals are provided a low-stress environment with extra space, fresh air and humane animal care," says Chris Oliviero, who leads the Niman Ranch network of independent meat producers. Niman Ranch animals that must be treated with antibiotics are not sold as meat.

FDA and American Veterinary Medical Health Association Push Back

Neither the National Cattlemen's Beef Association nor the National Pork Producers Council replied to Sentient Media's requests for comment.

Answering the criticisms raised here, the Food and Drug Administration said in an email that it is "committed to the judicious use of antimicrobials in food-producing animals" and that it continues to take "many actions to promote judicious use, reduce inappropriate use .... [and] try to curb the development of antimicrobial resistance (AMR) that could stem from antimicrobial use in food-producing animals."

Those actions, it said, include rules that now ensure "all medically important antimicrobials for food-producing animals are only available under the supervision of a licensed veterinarian."

Asked about policies to restrict antibiotic use on factory farms elsewhere in the world, the email said U.S. laws and livestock population "are not the same as that of the EU or other countries. The FDA's initiatives to promote judicious use and reduce AMR were devised specifically for the U.S."

It added that there are "many factors to consider" when analyzing antimicrobial sales data. These include sales volume fluctuations "in response to various factors, including changing animal health needs or changes in animal populations that may make certain antimicrobial drugs more medically important at various times."

The American Veterinary Medical Health Association also replied, arguing that antimicrobial sales data is "a valuable indicator of market trends" but that it "does not necessarily reflect the actual use of antimicrobial drugs." Pointing to more detailed biomass data, which includes animal weights, the association further suggested that higher animal numbers might be a factor saying that "... overall, animal populations have been growing annually since 2016 ... [which would] impact the amount of antimicrobials sold and could be one factor contributing to an increase in antimicrobial sales."

Yet according to FACT's Steven Roach, a closer look at the data suggests sales may be even higher. "If you look at the more detailed biomass data referred to by the AVMA it shows that animal numbers were down in 2022 compared to 2021 so when corrected for biomass the [medically important anti-microbial] sales increases are even larger."


Sophie Kevany wrote this article for Sentient.


get more stories like this via email

As federal Medicaid cuts loom, consumer advocates are celebrating Washington's new bill limiting hospital prices for state and public school employees.

Senate Bill 5083 caps reimbursement rates for nearly 700,000 people covered by the Public Employees Benefits Board and School Employees Benefits Board.

Sam Hatzenbeler, legislative director for the Economic Opportunity Institute, said public and school employees pay more than twice what the federal government said is a fair price for Medicare, with some hospitals charging up to four times more.

"At a time when everyone is going to be asked to tighten their belts due to federal cuts, it's more important than ever to be prudent with our health care resources," Hatzenbeler contended.

Washington hospitals pushed hard against the bill, warning it will add pressure to their already stretched budgets. Hatzenbeler pointed to a similar law passed in Oregon in 2019, which saved the state more than $100 million and cut out-of-pocket costs for patients by nearly 10%.

Adam Zarrin, director of state government affairs for the Leukemia and Lymphoma Society, said large hospitals consolidating through buying up their competitors is one of the reasons health care costs have grown out of control.

"States can and should take action to try to increase competition in this health care space," Zarrin argued. "Because we know that those market factors can help drive and keep costs down."

Public and school employee health insurance rates have risen more than 6% annually since 2021, compared to roughly 10% annually for other plans. Hatzenbeler added while the cap is a step forward for public workers, lawmakers must expand the relief statewide.

"The data tell us that there are plenty of ways to trim excessive spending," Hatzenbeler emphasized. "For example, we can look at healthcare CEO salary data. But we simply can't shift more costs onto the backs of people who are already struggling to get health care."

Nearly 1,000 New Mexicans have already accessed a new online portal which provides transparency about how much the cost of prescriptions and medical procedures vary from one location to another.

Introduced in 2024, the state service now has been updated to include costs in Spanish for the first time.

Ervin Garcia, health systems epidemiology program manager for the New Mexico Department of Health, said in addition to prescriptions, the portal shows the average costs for doctor visits and medical procedures.

"They can compare how much it would cost in one city versus the other because when you search you can put in your ZIP code and it tells you the closest around you," Garcia explained.

Research suggests health care quality is enhanced when people know what they will pay ahead of time. It also shows most people take at least one prescription drug, and lower prices help people better maintain overall health and wellness.

Garcia noted the online service could be a lifesaver for folks prescribed medicines or procedures who do not feel comfortable revealing their financial or insurance status to medical professionals.

"This kind of helps ease the health care procedures that way, so that they can kind of get a familiarity on how much it would cost," Garcia added.

Americans do not necessarily take more medications than people in other wealthy countries but federal government data from 2022 show U.S. prices across all drugs including generics were three times as high as prices in comparable countries.


get more stories like this via email

By Marilyn Odendahl for The Indiana Citizen.
Broadcast version by Joe Ulery for Indiana News Service reporting for the Indiana Citizen-Free Press Indiana-Public News Service Collaboration.

In a move applauded by advocates and lawmakers alike, the Indiana General Assembly will be taking a closer look at the estimated $2.2 billion in medical debt that is saddling many Hoosiers and often causing a devastating impact beyond the household budget.

“We all want to be able to care for ourselves and our loved ones, but medical debt poses undue financial hardship that prevents this from being a reality for countless Hoosiers,” Zia Saylor, researcher at the Indiana Community Action Poverty Institute, said in a press release. “It is important that lawmakers recognize the medical debt crisis we have and the urgent need for policies to address it.”

The Legislative Council included medical debt among the 22 topics that it assigned for further examination by the interim study committee process this summer and fall. On Wednesday, the council members unanimously passed a resolution that divided the topics between more than a dozen interim committees.

Initially, the Legislative Council began with 100 proposals for study topics this summer, plus 300 agency reports that presented more topics for possible review, according to George Angelone, executive director of the Legislative Services Agency. Through a “bipartisan process,” the list was whittled down to less than two dozen.

Other subjects scheduled for study include the economic value of Indiana’s public land for recreation, barriers to entering licensed professions, teaching water safety as part of the K-12 curriculum, salaries for K-12 administrators, the usage and cost of long-term-care insurance, and pollution caused by improperly discarded cables. Also, the Government Reform Task Force has been charged with reviewing the “efficiency and effectiveness” of various state boards, commissions and councils, and the Artificial Intelligence Task Force, established by state statute in 2024, will continue to examine the use of AI technology and the potential effects on Indiana residents’ constitutional rights, employment and economic welfare.

After the council hearing, Senate President Pro Tempore Rod Bray, R-Martinsville, said the work of the interim study committees are an important part of the legislative process. It allows state representatives and senators to dive into the topics and enables the public to provide input as well, which is helpful, he said. Bray and House Speaker Todd Huston, R-Fishers, serve as chair and vice chair, respectively, of the Legislative Council, which is comprised of eight members of the Indiana Senate and eight members of the House.

“Maybe it doesn’t end up in a proposed bill for the next legislative session, but people are always going to walk away with more facts and more information about that particular subject,” Bray said.

Democratic lawmakers were upbeat about the assignments to the committees. Senate Minority Leader Shelli Yoder, D-Bloomington, said the Democrats pushed topics that focused on improving Hoosiers’ lives. Many families, she said, are struggling to raise their children, care for their aging parents and stretch their wages to cover rising costs.

“That why our caucus fought very hard to make sure that this year’s study committee didn’t just check a box (but) that they had something meaningful to offer to Hoosiers,” Yoder said after the hearing. “We pushed hard for real topics, real impact and we have many successes to point to.”

‘Medical debt is no-fault debt’

For Democrats, the legislature’s decision to study medical debt is a win.

The interim study committee on the courts and the judiciary has been tasked with examining medical debt, the only topic on its agenda. As part of its study, the committee will look at financial protections for individuals through caps on monthly payments for such debt and limitations on collections or liens on property, along with restrictions on garnishment of wages. Also, the committee will focus on nonprofit and county hospitals by reviewing the definition for charitable care and the requirement to offer payment plans in addition to notices about medical bills to patients.

Speaker Huston and Sen. Fady Qaddoura, D-Indianapolis, both suggested the medical debt topic.

Huston said the topic was spurred by the many different constituents who reached out, telling their stories of the immense financial burden that overdue medical bills can be.

“We will at least take a look at it and understand it, particularly for low-income folks or people that have had some kind of… large, expensive medical procedures,” Huston said of medical debt. “How do you help them get out from behind the eight ball? We’ll take a look at that and see what the options are.”

During the 2025 legislative session, Qaddoura introduced Senate Bill 317 which sought to address medical debt by offering protections similar to those that will be studied by the committee. The measure died after it was narrowly defeated in a 26-to-23 vote in the Senate.

“We should stop penalizing people for getting sick,” Qaddoura said in a statement. “Medical debt is often unavoidable and disproportionately affects those already struggling. Our goal should be to create a path forward that lifts people up, not holds them back.”

Indiana residents are some of the most burdened with medical debt in the country. A 2022 study by the Indiana Community Action Poverty Institute, Grassroots Maternal and Child Health Initiative, and Prosperity Indiana, found that residents of the Hoosier state had the 11^th highest share of medical debt in collections nationwide, which equals $2.2 billion outstanding and was the highest among the state’s Midwestern neighbors.

Delinquent or high medical debt contributes to a number of harmful consequences, according to the report. More than negatively impacting the financial health of a household, medical debt can degrade an individual’s physical and mental health. Also, unpaid medical bills can create barriers to credit and housing and can lead to garnishment of wages, property liens and reduced access to health care services.

“Medical debt is no-fault debt,” Dave Almeida, director of state government affairs for the Leukemia & Lymphoma Society, said in a press release. “It’s different from other debt because no one chooses to become sick, which means that no one should have to choose between putting food on the table, paying the rent, putting the kids through college, or engaging in life-saving treatment.”

Council bypasses some committees

Six study committee created by statute were not assigned any topics, including the elections body.

The interim study committee on elections has not met since 2017. However, bills that mostly restrict voting and elections have been introduced each legislative session, culminating in a flood of legislation this year that one voting-rights advocate described as “an assault on democracy.”

Bray did not express any concern about not giving any topics to elections and other committees, including education, public policy and public safety, and military affairs.

“We had a lot of legislation in those areas this last session and sometimes you’ve got to let some of those issues bake a little while … before you have a new issue that you really have to grapple with,” Bray said.

Yoder said she was disappointed that the Child Welfare Task Force was not assigned any topics. Passed this session with strong bipartisan support, House Enrolled Act 1273, authored by Rep. Dale DeVon, R-Granger, created the 22-member task force to study child welfare topics. The law requires the task force to submit two reports in October 2026 and October 2027, but does not specify any areas or subjects that should be studied.

Sen. Andrea Hunley, D-Indianapolis, was hopeful the study committees’ examination of the issues most concerning to families, such as clean water, maternal health and medical debt, would yield some legislation addressing key concerns in the 2026 General Assembly session.

 “We also know that a single study in the interim isn’t going to fix everything,” Hunley said. “But we also know that it can spark the change that is necessary. It can be the momentum builder that we need to make sure that we’ve got the momentum going into session, so that we can have the bipartisan support necessary to pass important legislation that this is the time where that happens.”


Marilyn Odendahl wrote this article for The Indiana Citizen.


get more stories like this via email