Viewpoints: Improving Drug Prices; Bundling Payments For Hip And Knee Replacements
A selection of opinions on health care from around the country.
Los Angeles Times:
Here's Why Drugmakers Are Held In Low Esteem
Are you befuddled by the cost of prescription drugs? There may be a legitimate reason. "It's certainly not an efficient market," Jason Doctor, an associate professor of pharmaceutical and health economics at USC, said about prescription drug prices. ... According to a recent study by Consumer Reports, one-third of patients said the cost of their usual prescription rose $39 on average over the last year. ... Among the drugs that saw the biggest jumps in prices were treatments for common ailments such as asthma, high blood pressure and diabetes. I asked about a dozen experts whether the drug market was rigged against consumers. The answer, surprisingly, was no. But they said there were steps that could be taken to improve things. (David Lazarus, 8/28)
Los Angeles Times:
Ohio's Nonsensical Attack On Abortion Rights
A bill in the Ohio Legislature that would ban a woman from having an abortion solely because of a prenatal diagnosis of Down syndrome is blatantly unconstitutional and probably unenforceable. The bill, still winding its way through the Ohio House of Representatives, would make it a felony for a doctor to perform an abortion if he or she knows the pregnant woman is seeking the procedure to avoid having a baby with Down syndrome. It would also require the state to revoke the doctor's license if the procedure were conducted. (8/27)
The Washington Post:
Robbing The Victims Of Lead Paint Poisoning
You know there is something terribly wrong with an industry when even those who profit from it concede the need for stricter rules and more oversight. Such is the situation in Maryland’s little-regulated world of structured settlement buyouts. People terribly damaged in childhood by lead paint poisoning are being robbed of the compensation that is supposed to sustain them. State lawmakers need to enact true protections, and those who have been complicit in exploiting these vulnerable people, including judges who have enabled opportunistic businesses, should be held accountable. (8/27)
Tampa Bay Times:
Expanding Medicaid Would Have Been Wrong Move
My organization, Americans for Prosperity, recently launched television and digital advertisements thanking state legislators for not expanding the Affordable Care Act. This paper responded with a critical editorial and some questionable claims about the federal money Florida is supposedly giving up. More importantly, the Times conflated Medicaid expansion with increased access to quality health — a claim they offer no facts to support. The cost of expanding Medicaid by 800,000 enrollees would be immense. Nearly every state that has expanded has experienced massive cost overruns. (Chris Hudson, 8/27)
news@JAMA:
Insurers Are Once Again At Odds With Hospitals And Physicians
The longest running battle in medical care is heating up again. I refer, of course, to the struggle between insurers and physicians, hospitals, and pharmaceutical companies. In recent weeks, Aetna and Humana announced their intention to merge, as did Anthem and Cigna. If these mergers go through, the “big 5” health insurers will be down to the “big 3.” Physicians and hospitals were not happy with the news. “Given the troubling trends in the health insurance market, the AMA believes federal and state regulators must take a hard look at proposed health insurer mergers,” said Steven J. Stack, MD, the group’s president, in a statement. ... For their part, the insurers argue that consolidation on their end is needed, among other reasons, to combat the growing size of medical groups and health care facilities. (David Cutler, 8/27)
The New England Journal of Medicine:
Mandatory Medicare Bundled Payment — Is It Ready For Prime Time?
In July, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule for a new Comprehensive Care for Joint Replacement (CCJR) program. The program would establish bundled payments for total hip and knee replacements, covering hospitalizations, professional fees, and all clinically related Medicare Part A and Part B services for 90 days after discharge, including skilled nursing facility care, home care, and hospital readmissions. ... CMS proposes implementing the 5-year program in 75 metropolitan statistical areas with approximately 750 hospitals beginning January 1, 2016. ... without risk adjustment, some hospitals will question the mandate to participate unless CMS offers additional financial protection. (Robert E. Mechanic, 8/26)
The Baltimore Sun:
Cancer Cuts Are Too Deep
The Centers for Medicare and Medicaid Services recently unveiled proposed changes to their payment approach for cancer care services delivered to American seniors. Hidden within the complicated language and updated payment codes lies a harsh reality for community-based oncology centers and, more importantly, the patients we serve. ... the proposed physician fee schedule for 2016 would cut payments to freestanding radiation facilities by 6 percent next year. This is on top of cuts to freestanding centers that have totaled nearly 20 percent over the last decade. (Denise Gooch, 8/27)
The Baltimore Sun:
Why Do Poor Kids Get More Cavities?
Despite decades of community water fluoridation, fluoride toothpaste use, improvements in nutrition and hygiene education, dental caries — also known as cavities — remain the most common childhood disease in America. They lead to pain, infections, nutritional deficits, lack of sleep, poor concentration, slower physical growth and a loss of about a dozen school hours per child. Families with incomes below the federal poverty line — often families of color — experience twice the incidence of dental caries compared with higher earning families. Part of the problem is that they're not receiving the treatment they need. A quarter of all children from low income families have not seen a dentist before kindergarten, according to the National Institute of Dental and Craniofacial Research. (Sarah Uehara, 8/27)
The New England Journal of Medicine:
Invisible Colleagues
[Ms. F and I] share a place of work: she as a janitor, and I, a resident. ... Shortly after I met Ms. F., she spent 2 months in a nearby homeless shelter because of financial insecurity brought on by her father's death. She continued to work during that time, earning about $12 per hour, similar to the income of many janitors at Maryland teaching hospitals. Today, she and her family have their own place, and she connects the dots between public assistance programs to satisfy their basic needs. ... Ms. F.'s story runs contrary to the purported mission of my academic medical center — and probably most others. We claim ... we seek to improve the health of our communities. ... The people who live near and work in these institutions appear to have no place in these missions: they are not celebrated as our colleagues, nor can they afford to be our patients. (Benjamin J. Oldfield, 8/27)