Health Policy News and Views
Compiled by Benita M. Dodd
I’m lucky enough to have a window office in a business complex that includes a dialysis center, a Lasik surgery center and a cosmetic surgery center. As I like to say, you can walk through the complex and get your eyes fixed and your nose fixed before you stop by the Georgia Public Policy Foundation here to get your philosophy fix …
Needless to say, I see my fair share of ambulances, sometimes dropping off or picking up, but quite often racing in with lights flashing. I never know what’s gone wrong. But physicians do know what can go wrong. Which is why this blog entry by Patrick Hsu, a cosmetic and reconstructive surgeon, is worth reading. Understandably, in an emergency, you’re not going to grill the medical professionals. But when it comes to elective surgery, Hsu reminds you to have a few good questions for the doctor about his credentials, the procedure and the outcome. It’s worth reading.
Getting a taste of your own medicine: An ER doctor, struck by a car, had to be transported to the hospital. It was not pleasant. “As a medical professional who became an accident victim and then a trauma patient, I was struck by the uneven nature of my care, which was marked by an overreliance on testing at the expense of my overall well-being. Instead of feeling like a connected patient at the center of care, I felt processed. This is disconcerting, especially at a time when patient-centered care — that is, care delivered with me, not to me or for me — is supposed to be becoming the new normal.”
Actions with consequences: Whooping cough has reached epidemic levels in California, the Los Angeles Times reports. Think it has anything to do with the newspaper’s other recent article about more parents refusing immunizations for their children? Doctors are fighting back, apparently. ZDoggMD has a Web series, “Dr. House of Cards.” In one episode henavigates an interaction with an “anti-vaccine mother” in a family medicine clinic, Frank Underwood-style. Watch closely at the 2:11 mark.
Subsidizing the developed world: The Affordable Care Act has been described as a large transfer of wealth, from wealthy Americans to those not as well-off. But writing in KevinMD.com, physician Peter Ubel says “the real transfer of wealth has been from United States to other developed nations, whose health care costs we have subsidized for many years by paying so generously for many of our health care services. No better example of this comes to mind than the price we pay for pharmaceuticals in the U.S. versus elsewhere.” He shares an interesting chart on what we pay for brand-name drugs here compared to peer nations.
Off-label use: The federal Food and Drug Administration has announced it plans to issue guidance by the end of the year regarding drugmakers’ marketing of approved drugs for unapproved uses. It will address how drugmakers should respond to unsolicited requests for information about off-label uses and include a framework for the distribution of medical journal reprints that include off-label data. Source: Wall Street Journal
The good, the bad and the ugly: Did you know that some hospitals are arranging loans for their patients to cover care? While the Affordable Care Act expands the number of people with health insurance, about 80 percent of people signing up for private health coverage through government-run marketplaces are choosing plans with high deductibles, according to Moody’s. “Today’s high deductibles are tomorrow’s bad debt,” according to an Urban Institute report. “Because of Medicaid expansion, we’re seeing fewer uninsured patients,” said one hospital spokesperson, but “We’re seeing people with $10,000 deductibles.” Some hospital officials say that, by using tools such as “patient liability calculators,” they are trying to give patients an idea of how much they’ll pay out of pocket before a procedure is done. Source: Columbus Dispatch
… Writing about the above, Dr. Josh Umbehr points out: “Then I hear a minority voice, strong, though, opposing my work as a cash-only clinic for exacerbating a two-tier health care system. The thing about direct care is the math: For $600 per year, I promise you, I can handle about 80% of what you would ever need treatment for. I can get you almost all of your medications, for dollars per year. Yes, dollars per year. And I’m here for you when you cut your finger in the middle of the night, when your child has a stomach flu.”
Learn more about direct primary care – “concierge care” in a video from a recent Foundation event, “Concierge Care for the Little Guy.”
Whoops: The Obama administration is contacting hundreds of thousands of people with subsidized health insurance to resolve questions about their eligibility, according to The New York Times. The administration reported that 8 million people signed up for coverage through insurance exchanges under the federal health care law. Now it reports finding discrepancies in applications from 2 million, who “reported personal information that differed from data in government records,” according to federal officials and Serco, the company hired to resolve such inconsistencies.
Nobody knows the trouble I’ve been: An Augusta Chronicle editorial notes that nobody knows what ObamaCare costs anymore – not even the Congressional Budget Office, which four years ago said it would reduce the deficit by $120 billion over 10 years. Now it says measuring the law’s fiscal impact is impossible because of all the changes. “Provisions of the Affordable Care Act significantly modified existing federal programs and made changes to the Internal Revenue Code,” according to the CBO. “Isolating the incremental effects of those provisions on previously existing programs and revenues four years after enactment is not possible.”
“This is Congress’ own budget adviser giving the verbal equivalent of a shoulder shrug to the central question facing the most sweeping legislation in a generation,” the Chronicle remarks. “So it’s official: The experts are unsure whether Obamacare – the largest expansion of government-subsidized health care – will reduce or increase the national debt. We’re not experts, but if we were forced to wager, we know exactly where we would place our bet.”
Quote of Note
“Paradoxically, the more we ‘study’ health care delivery and attempt to ‘retool’ it to solve problems it does not cause and cannot prevent, the more cost and waste we introduce. Let’s focus on cleaning up the clutter, removing administrative barriers, and allowing physicians to do what they were trained to do.” – Luis Collar, MD
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.)