- Kaiser Health News Original Stories 2
- Ouch! Vaccination Rates for Older Adults Falling Short
- Small Changes Can Have Notable Effects In Workers’ Coverage Or Costs
- Political Cartoon: 'Throwing Shade'
- Health Law 2
- Shoddy Oversight Led To Healthcare.gov Delays, Technical Issues And Cost Overruns, Audit Finds
- Bids To Manage Montana's Medicaid Expansion Higher Than State Expected
- Public Health And Education 1
- Aspirin Can Protect Against Heart Attack, Stroke And Colon Cancer For Some Patients, Panel Says
- State Watch 4
- Ferguson Study Highlights Health Disparities As Part Of The Problem
- N.C.'s Compromise Spending Plan Includes Medicaid Reforms
- Judge Sets Thursday Hearing On Ark. Decision To Cut Off Medicaid Funding For Planned Parenthood
- State Highlights: Calif. Voters Divided On Low-Cost Health Coverage For People In U.S. Illegally; Colo. Lawmakers Focus On Assisted Suicide Bill
From Kaiser Health News - Latest Stories:
Millions of Americans over 60 are risking illnesses by skipping their shots. (Phil Galewitz, 9/15)
As the fall enrollment window begins for job-based insurance, workers may see a number of changes in provisions such as wellness programs, dependents’ coverage and specialty drug spending. (Michelle Andrews, 9/15)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Throwing Shade'" by Dave Coverly, Speed Bump.
Here's today's health policy haiku:
BERNIE IS CREATING A BUZZ
And universal health care...
Sanders brings them back.
If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.
Sign up to get the morning briefing in your inbox
Summaries Of The News:
In hopes of avoiding this outcome, Republican congressional leadership is trying to quiet conservative anger over Planned Parenthood funding and related abortion issues. Backers of John Boehner, R-Ohio, who faces discord within his caucus over these issues, say the House Speaker is being “blackmailed” by hard-liners into supporting a shutdown.
The Washington Post:
Wary Of Shutdown, GOP Leaders Try To Refocus Abortion Debate
Republican congressional leaders, hoping to avert another government shutdown in two weeks, have embarked on a series of maneuvers in hopes of quelling the conservative anger in their party that is threatening to blow up plans to keep the government funded and functioning. (DeBonis and Snell, 9/14)
The Texas Tribune:
Cornyn: The Federal Government Will Not Shut Down
U.S. Sen. John Cornyn on Monday dismissed the idea of a federal government shutdown, saying instead that elected officials had a duty to serve despite disagreements within Congress. ... Cornyn’s comments come amid speculation over another federal shutdown continues to swirl, with Cornyn's colleague and presidential candidate Ted Cruz at the center of that speculation. Cruz has said for weeks that a shutdown is possible if Congress continued to fund Planned Parenthood. (Aguilar, 9/14)
House GOP Obsessed With Boehner's Future
Speaker John Boehner says he’s not worried about his political future, but the Ohio Republican’s fate has become an overwhelming obsession of House Republicans. His backers believe Boehner is being “blackmailed” by conservative hard-liners into supporting a government shutdown. His critics insist they just want their leader to do the right thing. The latest flash point for Boehner is the controversy over federal funding for Planned Parenthood. Hard-line conservative Republicans want Boehner to do whatever it takes to shut off funding for the group, even if it means a shutdown. They’re vowing to vote against any spending bill that allows such funding to continue. (Bresnahan and Palmer, 9/15)
In other news from Capitol Hill -
Drug Costs Could Factor In Senate Research Bill
Growing concern over the cost of prescription drugs – articulated on the presidential campaign trail and in Congress – could force authors of a Senate biomedical innovation package to address the topic later this fall. With a quarter of Americans saying they cannot afford their prescription medications and prices up an average of 12.6 percent in 2014, drug affordability is coming under greater scrutiny just as the Senate begins crafting bipartisan legislation to spur medical innovation. (Zanona, 9/14)
Senate Committee To Evaluate Patient Access To Medical Information
The Senate Health, Education, Labor and Pensions committee on Wednesday will continue its probe into federal health information technology efforts by exploring how patients can improve their care by accessing their own medical records. The committee has met regularly to burrow into the 5-year-old $31.3 billion electronic health-record federal incentive payment program. Previous hearings have focused on the issue of health information technology systems' interoperability, or lack thereof. (Conn, 9/14)
Campaign proposals from presidential candidate Sen. Bernie Sanders, I-Vt., include a government-run health care program that covers all Americans. News outlets also note his stances on women’s concerns, such as abortion rights and paid family and medical leave. This comes as Hillary Clinton, who is also campaigning to be the Democratic nominee, appears to be losing some of her support among women voters. On the GOP side of the ticket, Ohio Gov. John Kasich says he would repeal the parts of the health law he doesn't like but keep some of the other provisions.
The Wall Street Journal:
Price Tag Of Bernie Sanders’s Proposals: $18 Trillion
Sen. Bernie Sanders, whose liberal call to action has propelled his long-shot presidential campaign, is proposing an array of new programs that would amount to the largest peacetime expansion of government in modern American history. ... His agenda includes an estimated $15 trillion for a government-run health-care program that covers every American, plus large sums to rebuild roads and bridges, expand Social Security and make tuition free at public colleges. ... A campaign aide said additional tax proposals would be offered to offset the cost of some, and possibly all, of his health program. A Democratic proposal for such a “single-payer” health plan, now in Congress, would be funded in part through a new payroll tax on employers and workers, with the trade-off being that employers would no longer have to pay for or arrange their workers’ insurance. (Meckler, 9/14)
Sanders Renews Calls For Universal Health Care
Sen. Bernie Sanders (I-Vt.) is doubling down on his support for universal healthcare after weeks of mostly shying away from the topic on the campaign trail. In a speech Monday at Liberty University in Virginia, Sanders blasted the nation’s healthcare system for killing “thousands of Americans” every year who can’t afford insurance. (Ferris, 9/15)
The Washington Post:
Clinton’s Support Erodes Sharply Among Democratic Women
Hillary Rodham Clinton is suffering a rapid erosion of support among Democratic women — the voters long presumed to be the bedrock in her bid to become the nation’s first female president. ... On the stump, Sanders also appeals to women’s concerns, touting his support for abortion rights, equal pay, and paid family and medical leave. ... Clinton is holding several weeks of rallies billed as “Women for Hillary,” but the message she is delivering speaks to broad concerns, focusing heavily on the economic benefits of equal pay, better child care and reproductive rights.(Tumulty, 9/14)
The Columbus Dispatch:
Kasich Seeks ‘Fix,’ Not Repeal Of Health-Care Law
Already, [Gov. John] Kasich has set himself apart from other GOP candidates. He would push to repeal the parts of the Affordable Care Act he doesn’t like and keep the things he does, most notably Medicaid expansion, which he supports on moral grounds. According to campaign and administration officials, Kasich wants universal health coverage. He likes Obamacare requirements allowing children to stay on their parents’ insurance plans longer, coverage guarantees for those with pre-existing conditions, and subsidies to help lower-income families buy insurance. (Candisky, 9/15)
In the background -
The Wall Street Journal's CFO Journal:
Some Companies Balk At Disclosing Details Of Political Giving
Some disclosure holdouts say they don’t use company funds for political donations, making any policy in that area moot. ... Not everyone agrees. If companies “do zero” political contributions, “they could write that on the website with one sentence,” said Robert Jackson Jr., a professor at Columbia University’s law school. Other holdouts include health insurer Aetna Inc., whose shareholders have made political-disclosure proposals for four years in a row. ... Aetna already discloses contributions to candidates, political-action committees, party committees and trade groups. “The overwhelming majority of our shareholders agree that additional disclosure is not warranted,” said an Aetna spokesman, citing 25% support for Mr. DiNapoli’s proposal. In 2012, Aetna inadvertently revealed in filings that it had poured about $3 million into a group campaigning against the Affordable Care Act—contributions it hadn’t disclosed in its regular political report. (Monga and Murphy, 9/15)
The report identifies early failures by Centers for Medicare & Medicaid Services employees to monitor eight companies handling more than $600 million in contracts to build the site. Elsewhere, news outlets report on disappearing PPO options in Florida, rising insurance rates in Georgia and the impact of insurer mega-mergers on the cost and quality of care for consumers.
How Healthcare.gov Botched $600 Million Worth Of Contracts
The public employees responsible for overseeing $600 million in contracts to build healthcare.gov were inadequately trained, kept sloppy records, and failed to identify delays and problems that contributed to millions in cost overruns. That’s according to a new government audit, published today. It reveals widespread failures by the federal agency charged with managing the private contractors who built healthcare.gov. The audit is the first to document, in detail, how shoddy oversight by the Centers for Medicare and Medicaid Services (CMS), which manages federal health programs including Obamacare, contributed to the website’s early struggles. (Tozzi, 9/15)
Health News Florida:
2016 Florida Health Care Rates Raise A Question: Where Did The PPOs Go?
Florida’s health insurance market for next year is beginning to take shape, and there will be cost increases. But that’s not what’s raising eyebrows. In Florida, managed care health plans will dominate the market place, and the emergence of a new system has some wondering, what is an EPO? First the bad news. According to Florida’s Office of Insurance Regulation, healthcare costs will rise an average of 9.5 percent next year. Now, the good news: many consumers won’t pay that. (Hatter, 9/15)
Georgia Health News:
Health Insurance Rates Headed Up In 2016
Many Georgians buying individual or family health insurance will see double-digit increases in their premiums for 2016. Insurance rates approved recently by Georgia Insurance Commissioner Ralph Hudgens range from hikes of 27 percent and 29 percent for Alliant Health Plans’ individual policyholders to slight decreases for a few plans. (Miller, 9/14)
The Philadelphia Inquirer:
What Do Health Insurance Mergers Mean For You?
America’s biggest health insurance companies are about to become bigger. In recent months, Anthem announced plans to buy Cigna, and Aetna announced a deal to acquire Humana. That will leave only three major national companies. Will less competition lead to higher prices? Will it mean lower quality coverage? At a recent hearing of the House Judiciary Committee, an industry group, America’s Health Insurance Plans, tried to dampen those concerns, while the American Hospital Association and the American Medical Association, along with two health policy experts, warned that consumers could be in for rough ride. (Field, 9/14)
Montana officials are looking to have a private company oversee the expansion. Also in state Medicaid news, advocates for expansion in Kansas hope that the recent closure of a hospital might help their cause, and safety net hospitals in Florida are warning that cutbacks caused by the lack of expansion will affect the cost of care.
KRTV (Great Falls, Mt.)/MTN:
Cost Of Private Firm To Manage Medicaid Expansion In Montana Won't Come Cheap
The cost of hiring a private company to manage Montana’s Medicaid expansion could be a few million dollars a year – or it could be a lot more. Four health-insurance firms bid on the contract to manage the expansion of Medicaid, which will provide health coverage for thousands of poor Montanans. Every bid has proposed costs higher than originally estimated by the Bullock administration. For example, if 25,000 people sign up for coverage under the program next year, Oregon-based PacificSource would charge the state as much as $12 million to manage the expansion – and perhaps a one-time technology fee of $632,000. (Dennison, 9/14)
The Kansas Health Institute News Service:
Lawmaker Hopes Closure Of SEK Hospital Spurs Action On Medicaid Expansion
The scheduled closure of the hospital in the southeast Kansas community of Independence could create new urgency around the Medicaid expansion debate. Advocates of expanding the Kansas Medicaid program — known as KanCare — say the additional federal money it would generate would help stabilize a growing number of struggling hospitals in the state and might have helped save Mercy Hospital Independence. They point to estimates produced by the Kansas Hospital Association that showed expansion would have generated an additional $1.6 million in annual revenue for Mercy. (McLean, 9/14)
Tampa Bay Times:
Hospitals Point To Feds, Underfunding In FL And HMOs As Medicaid Costs Soar
Legislators are expected to get the official word on Tuesday that in the midst of the good news that Florida will have a surplus of $635 million in revenue, the cost of providing health care to the poor and uninsured continues to soar. Next year, the cost of Medicaid will rise by $600 million as more people become eligible for the program and the federal government steers the state $400 million less in Low Income Pool money than it received this year to reimburse hospitals for charity care. In anticipation that hospitals will be blamed for many of those rising costs, the Safety Net Alliance Hospital Alliance of Florida issued a statement Monday explaining that the state's chronic underfunding of Medicaid and federal requirements governing reimbursement rates for Medicaid HMOs are the reasons for the growth in the Medicaid budget -- not hospitals. (Klas, 9/14)
Doctors, hospitals and health systems are worried the new medical coding system, with more than 100,000 new codes for medical procedures and conditions, will be too much trouble and not worth the improvements officials promise to the quality of care. The switch happens Oct. 1.
Will ICD-10 Conversion Be Worth The Trouble?
The required Oct. 1 conversion to the ICD-10 coding system will be worth the costs and headaches, supporters say. With up to seven alphanumeric characters in ICD-10 compared with a maximum of four numeric digits in ICD-9, there will be lots more room for the codes to accommodate new medical conditions and procedures. With ICD-9, “we've just run out of space,” said Lynne Thomas Gordon, president of the American Health Information Management Association. (Conn, 9/12)
Flipping The Code Switch: Health Care Industry Nervous About Readiness For Big ICD-10 Conversion
Ready or not, the U.S. healthcare industry is poised to flip the switch from the ICD-9 to the ICD-10 diagnostic and procedural coding system on Oct. 1, significantly changing how billions of dollars in medical claims are calculated and billed every day. Experts predict most large hospitals and health systems and most large physician groups will weather the federally required conversion just fine, though they could experience temporary cash-flow squeezes because of ICD-10-related payment delays. The organizations most likely to have trouble, however, are smaller providers, particularly smaller physician practices. (Conn, 9/12)
A daily low-dose aspirin for people in their 50s, and some in their 60s, who have a 10 percent or greater chance of having a heart attack or stroke in the next 10 years benefit the most, according to draft guidelines from the U.S. Preventive Services Task Force.
The Washington Post:
Expert Panel: An Aspirin A Day Can Help Keep Heart Attacks — And Cancer — Away
The announcement marked the first time the U.S. Preventive Services Task Force, an independent advisory panel of medical experts, has endorsed the combined benefits of aspirin in preventing cardiovascular problems and colorectal cancer in certain patients. Those conditions collectively kill hundreds of thousands of Americans each year. (Dennis, 9/14)
Panel Says Aspirin Lowers Heart Attack Risk For Some, But Not All
Millions of Americans take baby aspirin every day to prevent a heart attack or stroke. If they are at high risk of heart disease, they're doing the right thing, according to draft recommendations issued Monday by the U.S. Preventive Services Task Force. The independent panel also said that taking low-dose aspirin daily for at least 10 years may also protect against colorectal cancer, at least in people who are already taking it to prevent heart attacks and stroke. (Neighmond, 9/15)
The Associated Press:
Panel Backs Aspirin For Heart Health In Only Certain Adults
A government task force says a daily low-dose aspirin could help certain people in their 50s and 60s prevent a first heart attack or stroke — and they might get some protection against colon cancer at the same time. The U.S. Preventive Services Task Force issued draft guidelines Monday recommending aspirin only if people meet a strict list of criteria — including a high risk of heart disease and a low risk of bleeding side effects. (Neergaard, 9/14)
The commission's report said the racial divisions evident in St. Louis are rooted in social problems such as shortcomings in health care, housing and quality education.
The Wall Street Journal:
Ferguson Study Says Root Causes Of Racial Inequity Need To Be Addressed
The panel reported that similar criminal-justice issues were a problem across the St. Louis area. The members were tasked with determining the underlying causes of inequity and offered 189 policy recommendations covering education, job training, health care and other quality-of-life issues. ... For example, in the St. Louis area, life expectancies vary by nearly 40 years between those living in a wealthy, predominantly white ZIP Code and residents in a mostly black one. And according to a survey cited, nearly 18% of black residents lack health insurance, while just more than 7% of white residents are uninsured. (Kesling, 9/14)
Broad Change Needed to Heal Racially Divided Missouri: Report
The commission's report said the racial divide through the St. Louis region is deep and cuts across access to healthcare, housing and high-quality education, and fosters injustice in the courts. ... Among other recommendations: improved public transportation; more quality, affordable housing; expanded Medicaid eligibility; expansion of nutrition assistance programs for poor people; a higher minimum wage; improved education; and the establishment of school-based health centers. (9/14)
The state budget blueprint would spend $225 million over two years to reshape the state-federal health insurance program for low-income people from a system that pays for every doctor’s visit and procedure into a per-person payment approach.
Budget Deal Includes Sales Tax, Medicaid Reform
Legislative leaders on Monday unveiled details of their compromise $21.7 billion spending plan for the 2015-16 budget year – 76 days after it was due. The state budget resolves conflicts between the House and the Senate over education funding, Medicaid reform and sales tax distribution, and House Speaker Tim Moore and Senate President Pro Tem Phil Berger both expressed confidence at getting the budget passed and signed into law by a Friday deadline. ... The budget includes $225 million over two years to reform the Medicaid program. Cost overruns in Medicaid, which provides health coverage for more than 1 million poor and disabled North Carolinians, have been a budget problem for years, but the House and the Senate have long disagreed on how to move Medicaid from a fee-for-service system into more of a managed care operation. (Leslie, Binker and Burns, 9/14)
North Carolina Health News:
NCGA Compromise Budget Commits To Medicaid Reform, But Details Remain Slim
Members of the health care community who have been waiting for months, actually years, for a final deal on the long-anticipated overhaul of North Carolina’s Medicaid program will have to wait a few days longer. That’s because language on Medicaid reform is not in the final state budget, but in a separate bill that will be made public later this week or early next. (Hoban, 9/15)
Raleigh (N.C.) News & Observer:
Education Items, Some Tax Credits Restored In Budget Compromise
The budget spends $225 million over two years to transform Medicaid from the system where the state pays for every doctor’s visit and procedure to a per-person payment. Although details on how the money would be spent were not available Monday afternoon, Sen. Louis Pate, a Mount Olive Republican, said the money would be used to “stand up the new entity and keep the existing entity going.” A separate bill that would transform the Medicaid program calls for statewide commercial Medicaid managed care companies to operate alongside regional Medicaid health plans offered by hospitals and providers. The state now contracts with Community Care of North Carolina, networks of doctors, to manage Medicaid patients’ care. The budget would allow CCNC to continue to operate until 2017, Pate said. (Campbell, 9/14)
A federal judge has scheduled arguments for 2 p.m. Thursday regarding the reproductive health organization's request for an injunction to prevent the state from terminating its Medicaid contract.
The Associated Press:
Judge Sets Hearing On Arkansas Defunding Planned Parenthood
A federal judge has set a Thursday hearing over Arkansas’ decision to cut off Medicaid funding to Planned Parenthood. U.S. District Judge Kristine Baker on Friday set the hearing over Planned Parenthood’s lawsuit challenging Gov. Asa Hutchinson’s decision to cancel the organization’s Medicaid contract. The state’s cancellation of the contract took effect Sunday, and Planned Parenthood says it’ll affect Medicaid patients scheduled to visit its health centers starting Sept. 21. (9/14)
Hearing Set In Group's Suit Over Medicaid Cutoff
A federal judge will hear arguments at 2 p.m. Thursday on Planned Parenthood's request for an injunction to stop the state from terminating its Medicaid contract with the health care organization. Planned Parenthood of the Heartland provides family planning and preventive health services in Arkansas and Oklahoma. The nonprofit filed a federal lawsuit Friday in Little Rock over the Arkansas Department of Human Services' cancellation of the contract at the order of Republican Gov. Asa Hutchinson. (Satter, 9/15)
Health care stories are reported from California, Kansas, Montana, Michigan, Oregon, and Massachusetts.
Los Angeles Times:
California Voters Sharply Disagree On Low-Cost Healthcare For Immigrants
California has adopted a series of laws in recent years to help people in the country illegally, and polls show broad support for a pathway to citizenship for the estimated 2 million such immigrants living in the state. But it's a different story when it comes to providing them healthcare benefits. California voters are sharply divided over whether free or low-cost health insurance should be granted to those who reside in the state without legal status, according to a new USC Dornsife/Los Angeles Times poll. (Carcamo, 9/15)
The Denver Post:
California's Assisted Suicide Bill Boosts Colorado Effort
Friday the California legislature passed a bill to allow assisted suicide that, with Gov. Jerry Brown's signature, would make the country's most populous state the fifth to allow terminally ill residents to end their life. Rep. Lois Court, a Denver Democrat, aims to make Colorado the sixth. Court and fellow Democrats Joann Ginal of Fort Collins and Sen. Lucia Guzman of Denver fought for a bill nearly identical to California's in the last legislative session. It died in a House hearing, with some of those voting no saying they could support a bill with more protections against abuse. Court on Monday morning was busy setting up meetings with groups that have concerns to help draft those protections. (9/14)
Crain's Detroit Business:
Michigan Bill Would 'Level Playing Field' Of Health Insurance
Long-awaited legislation to reform Michigan's insurance code is expected to be introduced within the next two weeks by Rep. Tom Leonard (R-Dewitt), chairman of the state insurance committee. Ever since Detroit-based Blue Cross Blue Shield of Michigan won state approval in 2013 to convert into a nonprofit mutual health insurer from its 33-year run as the state's insurer of last resort, competing health insurers have been expecting the state to heed their calls to update and modernize the state's 60-year-old insurance code. (Greene, 9/14)
Managed Care Tax Left Hanging
The California Legislature, now adjourned until Jan. 4, passed a flurry of bills in the last days of session, but restructuring the managed care organization tax was not among those final orders of business. That leaves the Legislature to take up the issue in 2015, just months before the current MCO tax expires. That expiration will leave a $1.1 billion hole in the Medi-Cal budget -- a deficit that was the central reason the governor in June convened the special session on health care. (Gorn, 9/14)
The Associated Press:
Lawmakers Say State Must Measure Mental Health Progress
A state agency must determine how to track the effectiveness of millions of dollars being injected into Montana's mental health care system, lawmakers asserted Monday. The Children, Families, Health and Human Services Interim Committee heard positive feedback on the $18.7 million funding package that passed this year. But health care providers said they're not sure what data to collect to demonstrate whether new and expanded programs are successful. (Noon, 9/14)
The Associated Press:
Portland State University Gets $3.5 To Study E-Cigarettes
Chemists at Portland State University have been granted $3.5 million in federal funding to study the potential dangers of e-cigarettes. The Oregonian reports PSU released a statement saying the five-year grant from the National Institutes of Health will go toward a comprehensive examination of the health effects of e-cigarettes. PSU researchers have already conducted several studies on e-cigarettes, which allow nicotine users to inhale vapor and have become increasingly popular substitutes for tobacco cigarettes. (9/14)
New Electronic Cigarette Regulations Set To Go Into Effect In Mass.
Those under the age of 18 will no longer be allowed to purchase electronic cigarettes in Massachusetts under new regulations filed by Attorney General Maura Healey. The regulations also ban promotional giveaways or other free distribution of e-cigarette products and require that any nicotine liquid or gel be sold in child-resistant packaging. Retailers must also move any e-cigarette products to locations only accessible to employees and all sales must be made through face-to-face exchanges — much like regular cigarettes. (9/15)
Activists Submit Signatures For California Condoms-In- Porn Vote
A campaign to require condom use in pornographic film productions in California has submitted enough signatures to election officials before Monday's deadline to put a ballot measure before state voters in 2016, organizers said. "Unlike most politicians, voters are not squeamish about this issue, seeing it as a means to protect the health and safety of performers," Michael Weinstein, president of AIDS Healthcare Foundation (AHF) and a backer of the measure, said in a statement. (9/14)
A selection of opinions on health care from around the country.
Fighting The Good Fight
First it was ObamaCare. Then it was immigration. And now, it’s Planned Parenthood. So many who constitute the Tea Party wing of the Republican conference want to see their leaders wage war against President Obama. ... I venture to say that when it comes to ObamaCare, the [GOP] leaders hate it as much as their followers. The president’s executive order on immigration offended the leaders, not only on policy grounds but also as a matter of the constitutional probity. And for Boehner, who invited Pope Francis to address the Congress, the actions of Planned Parenthood pierced his Catholic soul. But there are good fights and there are stupid fights. And unfortunately, some on the hard right, including some members of the so-called Freedom Caucus and, yes, one particular presidential candidate, mistake stupid fights for good ones. (John Feehery, 9/14)
Legislative Fix Would Help Protect Small Businesses From Risk Of Increased Healthcare Costs
Under the Affordable Care Act, the definition of small group market is scheduled to expand from employers with up to 50 employees to include employers with up to 100 employees. A recent actuarial report projects that approximately two-thirds of mid-sized businesses, their employees and their families could see an average 18 percent premium increase due to how the Affordable Care Act expands the definition of the small group market. ... Premium increases could destabilize the market in these newly expanded small group markets, and a disruption could worsen over time as more and more mid-sized employers opt to avoid the new requirements and related premium increases. Those left in the newly expanded small group market could see significant premium hikes, according to experts. (Sens. Tim Scott, R-S.C., and Jeanne Shaheen, D-N.H., 9/15)
The Washington Post:
Louisiana’s Attack On Women’s Health
Need a breast exam? Call your dentist. What about an HIV test or pap smear? Find your friendly ophthalmologist. Looking for a birth-control refill? No problem. Visit your local nursing home. These were Louisiana’s utterly unhelpful, sublimely ridiculous recommendations for where to send the 5,200 low-income patients who will lose access to reproductive health services if the state cuts off Medicaid funding for Planned Parenthood, as Gov. (and flagging Republican presidential candidate) Bobby Jindal wants. (Catherine Rampell, 9/14)
Los Angeles Times:
Imagining U.S. Seniors In A World Without Medicare
It's pretty well known that Americans pay more for health insurance and medical treatment than people in other developed countries — at least until they turn 65 and are eligible for Medicare. But what would things look like if the government-run insurance plan wasn't an option? Kaiser Permanente provided a glimpse of such a prospect when it notified Chatsworth resident Layne Smith recently that his monthly insurance premium would double on Jan. 1 to $1,816.65 from $904.54. Why? Because of "a standard yearly rate change based on your age." Smith turned 65 on Monday. (David Lazarus, 9/15)
Ben Carson: Veterans Health Care Needs Bold Reform - I Know From Inside
A few days before Labor Day, as Americans prepared for the end of summer, we learned that some 300,000 U.S. veterans might have died while waiting for health care at the U.S. Department of Veterans Affairs. Yet due to “generally unreliable” VA data and ineffective systems, even this critical statistic could not be confirmed. These disturbing findings, revealed in a report by the agency’s inspector general, confirm the urgency for VA reform. When it comes to veterans care, Americans are rightfully outraged, and can no longer be content with business as usual: We must seek — and our veterans deserve — real improvements that are bold and long-lasting (Dr. Ben Carson, 9/14)
The Philadelphia Inquirer:
Will High Drug Prices Boomerang On Pharma
As surely as the seasons change and the tides rise, pharma will continue raising the prices of medications wherever and whenever it can. In one example from last week, the non-profit Institute for Clinical and Economic Review (ICER) found that the new class of cholesterol medications, the PCSK-9s, is grossly overpriced. The first two brands in that class, Repatha from Amgen and Praluent from Sanofi and Regeneron, each go for wholesale prices of more than $14,000 per patient per year. ICER's analysis concluded that a price representing the true value of those products would fall somewhere between $3,615 and $4,811 a year, a 67 percent discount below their current prices. (Daniel R. Hoffman, 9/14)
Los Angeles Times:
Do You Want To Die At Home? Here's Why You Probably Won't.
One of the few things that people across all backgrounds and cultures value in common is home. An overwhelming amount of research from around the world has shown that home is where most patients and their family members would like to take their last breath. But not everyone has that option. (Haider Javed Warraich, 9/14)
Los Angeles Times:
No Surprise: Conservative Sneers That Public Employees Like Their Pensions
Gallup reported that 82% of government employees were completely or somewhat satisfied by their retirement plans, compared with only 57% of private employees. There was a similar divergence on health insurance and vacation time. Public and private workers showed fairly close levels of satisfaction (factoring in margins of error) on job security, wages and their bosses. Public workers tended to report slightly lower levels of satisfaction with the recognition they receive on the job and with stress levels. ... The question raised by the Gallup survey is why public employees are so much happier with their retirement benefits than their private-sector counterparts. Gallup implies that the reason isn't so much that their benefits are higher, but that they're more dependable. (Michael Hiltzik, 9/14)
The Baltimore Sun:
The Unseen Epidemic
In general, the news media has a tendency to pay little attention to suicides unless they are tied to a murder, a celebrity or qualify as unusual in some way. The traditional thinking is that the last thing a newspaper or broadcast outlet wants to do is advertise or glamorize the behavior and thereby inadvertently encourage more people to take their own lives. The problem with this well-intentioned oversight is that it perpetuates a cultural stigma, an unspoken understanding that suicide is a taboo subject. But keeping silent is no way to address what is ultimately a public health issue — a point that advocates recently underscored as part of the recently concluded National Suicide Prevention Week. (9/14)
The New York Times' Well:
A Report Card The Doctor Doesn’t Want To Take Home
I got my report card the other week, and I must say I didn’t do very well. I’m pulling around a B, better than average but not by much. My parents would be appalled. I am graded these days not by test performance or classroom participation, but by my success in getting patients to do well. Not necessarily to feel well or to be well, mind you, but to perform well on their own tests. They do well, I do well. They do badly, I flunk. (Dr. Abigail Zuger, 9/14)
The New York Times' The Upshot:
What I Learned While Wearing A Heart Monitor
If the physical, mental and financial cost of collecting data about one’s body falls, more will take advantage of the technology. Out of curiosity, an abundance of caution, or for fitness reasons, people will monitor their hearts’ rhythms not just when their doctors order them to, but all the time. The data such widespread monitoring would generate might enhance researchers’ ability to learn early cues to potential problems. It might save lives. ... But, notice: These examples are for technology targeted to specific groups with significant heart problems, the people we know will benefit most. What happens when millions of healthy people start recording their hearts’ rhythms just because they can? Even though the devices that enable this may be cheap, collectively we may pay a lot if doing so leads to over-diagnosis and unnecessary procedures. People who need wearable health monitors the least may be among those most likely to use them. (Austin Frakt, 9/14)
The Washington Post:
Why The Catholic Church Should Talk About Contraception
When Pope Francis arrives in Washington this month, he'll be greeted enthusiastically. Among American Catholics, the pope is remarkably popular — 87 percent have a favorable opinion of him — and he's the U.S. church's best chance of overcoming a bad case of spiritual anemia. But excitement alone cannot heal one of the deepest rifts in Catholic life, not only among American Catholics but worldwide. It has to do with sexuality, although not the priest abuse scandals that have quite properly received attention in recent years. Nothing has divided the church more than its prohibition against contraception, even among married couples. (Peter Steinfels, 9/14)
The Promotion Of Medical Products In The 21st Century
On August 7, 2014, Federal District Court Judge Paul Engelmayer blocked the US Food and Drug Administration (FDA) from enforcing restrictions on the marketing and promotion of off-label use of the drug icosapent ethyl (Vascepa), manufactured by Amarin Pharma Inc.1 If the case heralds the future of jurisprudence, responsibility for the oversight of the truthfulness of pharmaceutical promotions may shift from the nation’s leading science-based regulatory agency, the FDA, to the courts. If it does, the market for medications in the 21st century may revert to a time of more claims and less evidence to guide clinical care. (Joshua M. Sharfstein and Alta Charo, 9/14)