Health Policy News and Views
Compiled by Benita M. Dodd
The good news: The number of deaths from motor-vehicle crashes declined by 5 percent during the first six months of 2013 compared with the first six months of 2012, according to preliminary data collected by the National Safety Council. The council estimates that 16,620 traffic deaths occurred from January through June, compared with 17,430 deaths during the same period last year. The cost of motor-vehicle deaths, injuries and property damage through June was $127 billion. The council estimates that there were 1.8 million medically consulted motor-vehicle injuries during the first six months of 2013, up 2 percent from 2012. Source: EHS Today
The bad news: Did you know that hospitals can reject your health insurance? Many hospitals are doing just that in auto wreck cases – so that they can collect a higher amount from the auto insurance settlement, according to a Kansas City Star Report. According to the Kansas City Star, hospitals first refuse to submit the bills to the health insurer. They calculate the bills without the health insurer discounts then file a lien against whatever settlement the patient might receive from an auto insurer. Then the hospital gets paid from that auto settlement while patients are left to dispute medical bills they thought would be covered by their health insurance. There are now companies specializing in helping hospitals obtain the 100 percent reimbursement from such settlements. The practice is thought to be growing as hospitals look for new sources of revenue. Now, patients are fighting back, siccing lawyers on some of the hospitals.
Genome sequencing in the womb: A number of companies now offer non-invasive prenatal tests that can, by isolating fetal DNA from the mother’s bloodstream, determine if the fetus has a chromosomal disorder. And, as Fortune‘s Clay Dillow writes, those tests may soon be able to detect even more disorders. “[I]f parents could know more about their child’s health before birth, wouldn’t they want to?” he adds. It’s not the science that is holding back the adoption of such tests but the cost, he writes.
FDA approves GlaxoSmithKline’s HIV-1 drug: GlaxoSmithKline obtained the FDA’s approval for Tivicay, or dolutegravir, in previously treated and untreated adults with HIV-1. The drug, an integrase strand transfer inhibitor that prevents the virus from entering cells, is taken once a day in combination with other antiretroviral medications. Tivicay was also approved for use in children 12 and older who weigh at least 88 pounds and haven’t previously received other integrase strand transfer inhibitors. FierceBiotech called the drug “a blockbuster candidate that analysts believe should do very well in competing against Gilead’s rival therapies.” This is GlaxoSmithKline’s fourth new drug approval so far this year after what FierceBiotech described as “some lean years on the R&D side.
HIV statistics: An estimated 50,000 Americans become infected every year with HIV, the virus that causes AIDS, according to the Centers for Disease Control and Prevention. At the end of 2009 (latest statistics available), an estimated 1,148,200 people age 13 and older were living with HIV infection in the United States, and 18 percent of those infected had not been diagnosed. In 2010, there were 15,529 deaths of people who had been diagnosed with AIDS; through 2010, the number of deaths totaled 636,048.
What goes into the cost of pharmaceuticals? Costs are so high because 95 percent of the experimental drugs studied in humans fail to be both effective and safe. According to a new analysis conducted at Forbes magazine, a company hoping to get a single drug to market can expect to have spent $350 million before the medicine is available for sale. In part because so many drugs fail, large pharmaceutical companies that are working on dozens of drug projects at once spend $5 billion per new medicine, the article notes.
A family that went to HeLa and back: The family of Henrietta Lacks, whose cells have been used in medical and genetics studies since the 1950s without her knowledge, agreed to allow controlled access to the HeLa cell genome. Lacks was a poor, young black tobacco farmer with cervical cancer whose tumor cells were taken without consent and used in 74,000 medical studies since the 1950s. She died in October 1951, at age 31. Her story became the subject of a book entitled “The Immortal Life of Henrietta Lacks,” in 2010 by Rebecca L. Skloot. NIH Director Francis Collins brokered the deal, describing to the family genomics and the importance of the cell line in research. Through the deal, the family has become willing participants in medical research while maintaining control over private data, Collins says.
Affordable Care Act
Thanks, but no thanks: Health and Human Services Secretary Kathleen Sebelius was in Atlanta Monday, addressing state legislators during a meeting of the National Conference of State Legislatures (NCSL). She said her agency is open and willing to discuss different proposals by states to expand their Medicaid programs, according to Andy Miller of Georgia Health News. “We are very eager to continue these conversations with states around the country. … I don’t think there’s any question that if you want a healthier population, looking at the opportunity to expand Medicaid has got to be a piece of the puzzle.’’Governor Deal has already rejected expanding Georgia’s Medicaid rolls. Kelly McCutchen, president of the Georgia Public Policy Foundation, has written an excellent proposal on an alternative to Medicaid expansion, noting, “the question should not be limited to whether to expand a specific program such as Medicaid it should be how to best provide access to quality health care to our poorest citizens in a way that is fiscally sustainable.
No limits on ObamaCare’s small print: The administration has delayed until 2015 the “significant consumer protection” in the Affordable Care Act that limits how much people may have to spend on their own health care, The New York Times reports. The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But way back in February, federal officials allowed the one-year grace period. It was outlined on the Labor Department’s Web site since February, but was “obscured in a maze of legal and bureaucratic language that went largely unnoticed.” It follows on the heels of the delay of ObamaCare’s Medicare cuts until after the election; the delay of the law’s employer mandate; and the delay in enforcement of a number of key eligibility requirements for the law’s health insurance subsidies, relying on the “honor system” instead. How about we delay ObamaCare … permanently?
Quotes of note:
“Serious illness doesn’t bother me for long because I am too inhospitable a host.” – Albert Schweitzer
“There’s lots of people in this world who spend so much time watching their health that they haven’t the time to enjoy it.” – Josh Billings
The Foundation’s Criminal Justice Initiative pushed the problems to the forefront, proposed practical solutions, brought in leaders from other states to share examples, and created this nonpartisan opportunity. (At the signing of the 2012 Criminal Justice Reform bill.)