Tuesday, March 29, 2016

Health Care Reform Articles - March 29, 2016

10 of the Worst Big Pharma Company Rip-Offs — and Their Plan to Keep the Gravy Train Rolling

Martin Shkreli isn't the only one putting high prices on life saving drugs. 

When did you become aware of the obscene prices the pharmaceutical industry is charging for drugs? For many it was when a smirking Martin Shkreli, founder of Turing Pharmaceuticals, testified on the Hill in February about his price hike of the antiparasitic drug Daraprim from $13.50 to $750, after which he called lawmakers “imbeciles” in a tweeted goodbye.

Surprise! You're covered for the hospital, not the doctors

by David Lazarus - LA Times

fter Dave Connors' teenage son broke his leg, he was rushed to an Orange County hospital that Connors knew was in his insurer's coverage network.
It was only after the bills recently started arriving that he learned the doctors and anesthesiologist in the operating room were out of network, requiring him to pay thousands of dollars more.
"When you're at a hospital that you know is in-network, who would think to ask individual people if they're also in-network?" Connors said. "Especially when your son is being operated on."
This wasn't an isolated example of our patient-unfriendly, for-profit healthcare system.

Nearly a quarter of Californians who had hospital visits since 2013 were surprised to find that at least some charges at in-network hospitals were at out-of-network rates, according to a survey last year by the Consumer Reports National Research Center.

How to Stop Overprescribing Antibiotics


ANTIBIOTICS are an indispensable weapon in every physician’s arsenal, but when prescribed unnecessarily for nonbacterial infections like the common cold, as they too often are, they provide no benefit and create problems. They wipe out healthy bacteria and can cause side effects like yeast infections and allergic reactions. Worse still, they contribute to the rise of “superbugs” that resist antibiotic treatment.

The Global War on Drugs Has Unleashed an International Health Crisis, Says Top Health Panel

Zero-tolerance policies have fueled lethal violence, disease transmission, discrimination and forced displacement.

A premiere public health commission warned Thursday that the global war on drugs and zero tolerance policies are unleashing an international health crisis by fueling “lethal violence, communicable-disease transmission, discrimination, forced displacement, unnecessary physical pain, and the undermining of people's right to health.”
A joint initiative of Johns Hopkins Bloomberg School of Public Health and the Lancet, the commission released a report calling for a global transformation of drug policy—towards decriminalization and harm reduction.

Obamacare is on back burner in the race for the White House

by Albert Hunt - Bloomberg View

No issue has aroused more partisan passion over the past six years than the Affordable Care Act. Yet, the law is playing only a secondary role in during the election.
Sure, Republican presidential candidates cater to their base by vowing to repeal and replace Obamacare, and on the Democratic side, Sen. Bernie Sanders of Vermont promises to replace it with a government-run universal coverage system.
But it doesn’t dominate the dialogue and isn’t a top priority on either side. Among the most embattled Senate Republican incumbents, the campaign websites of New Hampshire’s Kelly AyotteMark Kirk of Illinois or Ron Johnsonof Wisconsin barely mention the ACA. An exception is Pat Toomey of Pennsylvania.
The explanation may be that for all its controversy and imperfections, the sweeping law has taken hold. “This is in the fabric of the nation,” Health and Human Services Secretary Sylvia Mathews Burwell said.
To be sure, the presidential election outcome will be a determinant of whether Obamacare is reshaped, bolstered or downsized.

US Doctor Group Demands Price Controls for Out-of-Control Drug Industry

American College of Physicians publishes policy paper on getting skyrocketing drug prices under control
The American College of Physicians (ACP), a group of 143,000 internal medicine doctors, on Tuesday published a position paper calling on the government to do more to regulate the skyrocketing costs of pharmaceutical drugs.
The article, written by the ACP's Health and Public Policy Committee and published in the Annals of Internal Medicine, notes that the U.S. is one of the only economically advanced countries in the world that does not have any government regulation of drug prices.
"In the United States we pay comparatively much more for prescription drugs than other countries, an increasing concern for all Americans," said ACP president Dr. Wayne J. Riley. "The impact of these rising costs can be very detrimental to patients, causing them to forgo filling important prescriptions or not taking drugs on the schedule that they are prescribed."
The ACP made seven recommendations to help slow down and maintain the price of medicine, including:
Transparency in the pricing, cost, and comparative value of all pharmaceutical products;
Allowing price negotiation by Medicare and other publicly-funded health programs, consideration of reimporting drugs manufactured in the U.S., and increasing competition for sole-source drugs;
Ensuring that patient cost-sharing is not set at a level that imposes a "substantial economic barrier" to patients.
As NPR reports, the ACP also called for "drugmakers to disclose the actual research and production costs of developing and manufacturing each drug, and to disclose the prices paid for drugs—including discounts and rebates—that take advantage of basic research funded by the government, such as the National Institutes of Health and the Department of Veterans Affairs."

Thursday, March 24, 2016

Health Care Reform Articles - March 24, 1938

Even with insurance, Mass. residents often can’t afford care

By Felice J. Freyer - Boston GlobeNearly all Massachusetts adults have health insurance, but being insured is no guarantee patients can afford health care or even find someone to provide it, according to a survey released Wednesday.
Despite the state’s landmark health care overhaul, the report found, cost and access remain problems for a significant share of residents.

Medicare Proposal Takes Aim at Diabetes

by Robert Pear - NYT

WASHINGTON — The Obama administration plans on Wednesday to propose expanding Medicare to cover programs to prevent diabetes among millions of people at high risk of developing the disease, marking the sixth anniversary of the Affordable Care Act with the prospect of a new benefit, federal officials said.
Sylvia Mathews Burwell, the secretary of health and human services, is scheduled to announce the proposal at a Y.M.C.A. here. Under the plan, Medicare would pay for certain “lifestyle change programs” in which trained counselors would coach consumers on healthier eating habits and increased physical activity as ways to prevent Type 2 diabetes, formerly called adult onset diabetes. Such programs have been found effective in people with a condition known as prediabetes, meaning that they have blood sugar levels that are higher than normal but not high enough to be considered diabetes.

Soaring prescription prices cause a nasty divorce in the healthcare market

by Michael Hiltzik - LA Times
Money always ranks high among the reasons for divorce. In the failing marriage between Anthem Blue Cross and Express Scripts, it's reasons one through 15 billion. That's how many dollars the party of the first part thinks its been cheated by the party of the second part.
For those who missed the wedding announcement back in 2009, the first is the nation's second-largest health insurance company and his (or her) partner is the nation's biggest pharmacy benefits management firm, or PBM. They seemed to be in a marriage made in heaven, until household finances strained the relationship to the breaking point. To be precise, the issue is the run-up in pharmaceutical prices, which Express Scripts was tasked with moderating but -- according to Anthem -- failed to deliver or even pocketed the savings.

Maine sought to put struggling health insurance co-op into receivership

The Bureau of Insurance hoped to stem Community Health Options' losses, partly by ending as many as 17,000 policies, but a federal agency rejected the temporary plan.
by Edward D. Murphy - Portland Press Herald

Maine’s largest Obamacare insurer to raise rates

By Darren Fishell, BDN Staff
PORTLAND, Maine — Maine Community Health Options, the state’s largest individual health insurer, expects to raise rates for its 2017 plans after closing 2015 in the red.
The financial troubles have put the insurer under closer watch from state regulators, who said they tried to stop enrollment in the fall to stem projected premium losses estimated at $43 million for 2016.
The company posted a total $74 million shortfall last year, which includes the $43 million it will set aside to cover projected losses in the year ahead. In 2014, it was the only co-op in the country to turn a profit from its plans offered under the new Affordable Care Act.
Michael Gendreau, a spokesman for the insurer, said the insurer is not going to close and that state regulators’ scrutiny after 2015’s financial hit “does not affect our member’s coverage whatsoever.”

Our View: Insurance co-ops should have federal backing

The still-new organizations have not been given the time or financial support they need.
Editorial - Portland Press Herald
In just a year, Community Health Options went from being a national success story to a company on the verge of insolvency. It would be tempting to blame that change on local management, particularly the decision to give hefty pay raises to its top executives.
But if overpaying executives killed health insurance companies, there wouldn’t be any still in business.

Our View: Maine prescription compromise won’t heal flawed health care system

Limits on opioid dispensing here are a good start, but the addiction epidemic grows out of national policies.

PNHP Report Card: 2016 Selected Presidential Candidates’ Health Proposals 

By Physicians for a National Health Program
Updated March 22, 2016

How to Stop the Bouncing Between Insurance Plans Under Obamacare

by Dhruv Cruller - NYT

In a fight between nurses and doctors, the nurses are slowly winning

More states are allowing nurses to provide all the kinds of care they learned about in school.

Amid a flurry of legislation to pass in the final days of spring state legislative sessions last week, nurses won two more victories in a long war for independence.
For decades, most of the country has required physician oversight for nurses to conduct certain procedures, and especially to prescribe drugs. But that’s slowly changing, as the nation’s health-care needs rise, and nurses fight for the right to practice everything they learned in school.
The most recent wins came in West Virginia and Florida, where after many years of trying, lawmakers passed measures freeing up “advanced practice” nurses — those with more graduate education than just a nursing degree — to administer a wider range of care and prescribe most drugs without having to maintain a relationship with a physician.

Monday, March 21, 2016

Health Care Reform Articles - March 21, 2016

Medicare for all really is 'the only answer'

By the Editorial Board
The Capital Times (Madison, Wis.), March 16, 2016
Dr. Quentin Young, one of the greatest economic and social justice campaigners of the modern era, has died at age 92. Young served as a personal physician for the Rev. Martin Luther King Jr. and organized the Medical Committee for Human Rights, which provided medical support for activists during the 1964 Freedom Summer in Mississippi. He helped to shape and advance the call for an understanding of health care not as a commodity but as a human right.
Young was a friend and ally of this newspaper, a source of insight and inspiration for many years, and an ally in our campaigning for universal health care, which dates back to the days when Capital Times founder William T. Evjue was cheering on the efforts of Franklin Delano Roosevelt and Harry Truman to establish a national health care program. Over the years, we celebrated Young’s work and joined him and his dear friends, the late Madison area physicians Gene and Linda Farley, in championing efforts to establish a single-payer “Medicare for all” health care system in the United States.

Why business should favor a single-payer plan

By Tom DeLoe, Ph.D.
Gettysburg (Pa.) Times, March 10, 2016
If I were in business, I would favor a single-payer health plan. Instead of paying private insurance companies monthly premiums for health care coverage, each individual and business would pay the government through modest taxes. The government would negotiate health care services and costs for all of its citizens and pay providers directly for their services. Your business would no longer be responsible for the health care of your employees. Your business would pay a 10 percent payroll tax on your payroll directly to the government, and the health care of your employees would be provided by participating doctors and hospitals. So let’s look at what a single-payer system could do for you, your business, and your bottom line.

Patients in Pain, and a Doctor Who Must Limit Drugs

Tuesday, March 15, 2016

Health Care Reform Articles - March 15, 2016

No. Obamacare isn’t killing the insurance industry.

As health carriers blame losses on Obamacare, their stocks gains continue to be 'yuge,' thanks to one great customer: Uncle Sam

By Wendell Potter, March 1, 2016
The first seven years of the Obama administration have been “yuge” for the health insurance industry, to use one of The Donald’s favorite words.
To be more precise, it has been yuge — almost unbelievably yuge, in fact — for the well-heeled folks who own stock in the for-profit companies that dominate the industry, including Cigna and Humana, the two insurers I used to work for.’t-killing-the-insurance-industry

New Maine AllCare Chapter Forming in Blue Hill

by Joe Lendvai

Another View: Way to fight addiction 
is to make health care universal

A columnist had good ideas about how to treat people with addiction, but not how to pay for it.
by Daniel Bryant

What is Meant by 'Single-Payer' in the Current Discussion of Health Care Reforms During the Primaries?

By Vicente Navarro, M.D.
CounterPunch, March 10, 2016

Hospitals working to make intensive care less terrifying

For many patients, time spent in an intensive care unit is a deeply disturbing experience, and not just because they are suffering from a serious illness. They are often heavily sedated, encircled by beeping equipment, unable to talk or even think clearly. Doctors and nurses prod their bodies as scores of trainees watch.
“I could feel people touching me but I couldn’t move,’’ said Ashleigh Robert, 30, who spent three weeks in the ICU at Beth Israel Deaconess Medical Center in Boston awaiting a liver transplant. “It was extremely frightening.”

Christians Flock to Groups That Help Members Pay Medical Bills

Should a man taken to the ER in an ambulance against his will have to pay the bill?
by David Lazarus - LA Times
As George Varghese tells it, he was walking along a sidewalk in West Los Angeles when he tripped on a crack and fell to the ground, spraining his wrist.
"An ambulance appeared suddenly," he recalled. "Three men came out, checked my ID, laid me on a cart, pushed me into the van and took me to the emergency room."
That would seem like a model of paramedic perfection, except for one thing. Varghese, 79, said he didn't want to go to the ER.
"If I wanted to go to the emergency room, I could have taken a cab costing less than $10," he said.

Why the US health care system fails the smallest lives

Posted March 14, 2016
An important fact about our babies was lost in recent news, given all the distractions caused by the presidential wrestling matches. According to a recent report from the U.S. Centers for Disease Control, infant mortality rates in the United States decreased by 2.3 percent between 2013 and 2014, down to 582 deaths per 100,000 live births. Although this is the lowest U.S. infant mortality rate ever recorded, compared to other countries, we still have a long way to go, baby.

Can Cuban Medicine Help Solve American Inequality?

Nearly a hundred Americans are studying medicine at Cuba’s Latin American School of Medicine (ELAM), where they are taught preventive medicine to treat the underserved.

by San Loewenberg - The Development Set

Friday, March 11, 2016

Health Care Reform Articles - March 11, 2016

How Liberals Tried to Kill the Dream of Single-Payer 

Prominent progressives have undercut a cherished policy goal of the left. They’re wrong on both the politics and the economics.

BY March 8, 2016

Hillary Clinton reveals her plan to revise--not repeal or replace--Obamacare

'Medicare for All' vs. 'Government Plan': Nuance matters in coverage of health policy choices

By Trudy Lieberman
Health Review News, March 3, 2016

Groups Scrutinize White House Plan to Cut Drug Costs in Medicare

This drug is defying a rare form of leukemia — and it keeps getting pricier

by Carolyn Johnson - Washington Post

Officials Concerned About LePage’s Prescription Drug Bill

Mal Leary reports on a prescription drug bill.

Reeling from Losses, Maine Insurer Plans to Tap Reserves, Increase Premiums