Longer Looks: ‘Back-Door’ To Single-Payer; Predicting Cancer Survival; Paying For HIV Drugs
Each week, KHN's Shefali Luthra finds interesting reads from around the Web.
All-Payer Rate Setting: America’s Back-Door To Single-Payer?
Single-payer health care has long been the political pipe dream of the left, but there's a nearly identical system that could actually happen. All-payer rate setting, as the system is known, shares the same goals of single-payer: it aims to increase efficiency and reduce insurer overhead in the health care system. Single payer does this by eliminating private plans for one government plan. All-payer rate setting gets there by setting one price that every health insurer pays for any given medical procedure. (Sarah Kliff, 2/9)
U.S. News and World Report:
Are Doctors Exposing Heart Patients To Unnecessary Cardiac Procedures?
Dr. Gregory Sampognaro is one of the busiest interventional cardiologists in the United States, clearing out clogged coronary arteries in hundreds of patients every year. Sampognaro ranked 17th in the U.S. in 2012 in the number of these procedures, according to a U.S. News & World Report analysis of Medicare data. What makes these numbers noteworthy is that Sampognaro works not in a medical mecca like New York or Chicago but in Monroe, Louisiana, a fading Mississippi-delta agricultural community of 54,000 .... While no one has accused Sampognaro of doing anything wrong, experts who have reviewed the U.S. News data say it raises a critical question, not just for patients seeking coronary care in Monroe but for those in other parts of the country: How many of these catheterization procedures are medically advisable and how many put patients at unnecessary risk and add billions of dollars to the nation’s medical bill? (Steve Sternberg and Geoff Dougherty, 2/11)
Sleepy, Stressed, Or Sick?
Twelve percent of Americans will develop some sort of thyroid disorder within their lifetimes, and levothyroxine, the drug used to treat hypothyroidism, is by some measures the second-most-frequently prescribed drug in the country. For some reason, thyroid disorders are exponentially more common in women than men. [Hashimoto's thyroiditis, a condition in which the immune system attacks the thyroid] is hypothyroidism’s most common cause. Many people—possibly up to 2 million—who have a thyroid disorder haven't been diagnosed. Some might lack access to or money for doctors, but for many, it’s just that the symptoms of hypothyroidism are so vague. Who doesn't feel tired, fat, and depressed sometimes? (Olga Khazan, 2/9)
Cancer Patients And Doctors Struggle To Predict Survival
Anxiety makes it difficult to remember details – and the worse the prognosis, the less the patient tends to remember. Recent studies have found that cancer patients retain less than half of what their doctors tell them. So it's not surprising, perhaps, that a patient with advanced cancer can leave her oncology appointment thinking she has a set amount of time left to live. … But prognoses are almost never that clear-cut, despite the fact that patients need to make big decisions based on those numbers. (Amanda Aronczyk, 2/10)
The Daily Beast:
Even After Obamacare, It’s Still Way Too Hard To Get HIV Meds
Since the Affordable Care Act went into effect, Robert Shore’s health insurance premium has more than doubled, from $173 for a discontinued bare-bones plan with a $10,000 deductible to $373 for the least expensive bronze plan he could find on HealthCare.gov. Then in November, the Ft. Lauderdale man’s health insurance went up again under Obamacare, as the ACA is popularly known. The reason? Shore, a gay man, wanted to make sure he was as protected as possible from HIV. And that meant finding a plan that would allow him to afford the only medication approved by the Food and Drug Administration for HIV prevention. (Heather Boerner, 2/8)