Health Policy News and Views
Compiled by Benita M. Dodd
My pet peeve when I visit the doctor’s office is waiting.
I arrive on time. Then I wait. I don’t touch the magazines – I mean, sick people visit the doctor’s office! I play with the iPad. I text. I attempt to diagnose patients’ ailments and personalities.
Most of all, I seethe. I know that if I made the doctor wait for me, I’d lose my place in line and they wouldn’t accommodate me. And if I didn’t turn up at all, they’d charge me for the missed appointment.
Making me wait, I feel, is a sign of disrespect and disregard for my time. Is my time not worth money, too?
Yesterday, I waited until 4 p.m. for my 3:10 appointment. All I needed was a simple blood test. But when I made the appointment I was told I had to see the physician, not just the technician. I was visibly unhappy when she walked in, even when she apologized profusely and told me she hadn’t even had a chance to eat lunch yet. Is it my problem that you’re that much behind? This isn’t an emergency room …
Lo and behold, I sat down today to gather items to share in my weekly column and there, in KevinMd.com, was a post by a physician about when we should forgive a doctor who’s running late. Justin Smith, a pediatrician, warns, “I’m not one to defend the status quo, but I’m going to go ahead and defend the status quo a little bit.” Acceptable reasons are scheduling and emergencies. Then he details unacceptable waits – including a doctor who read the paper cover-to-cover in his office every morning while patients waited. I’d be interested in your experience.
ObamaCare
The good news in ObamaCare: Many Americans who were considered uninsurable now have affordable policies under the Affordable Care Act.
The bad news in ObamaCare: Unfortunately, the above has shifted the cost burden for those who already had insurance, who now face costlier policies with higher deductibles, the Daily Signal reports. “In general, healthy people are paying more and unhealthy people are paying less,” says a source who supports and helped implement Obamacare but is disappointed with the results to date, “with those above-average [income] tending to pay more and those below-average [income] tending to pay less.” Is the new law effective in reducing the number of uninsured? “Yes, but so far not very,” he says.
Distance adds disenchantment: The Obama administration immediately trumpeted the number of 8 million enrolled in the exchanges by the deadline. Two-and-a-half months later – when you’d think the picture would become even clearer – officials have clammed up on who’s actually enrolled. The Daily Signal (link above) reports that officials counted people who weren’t actually covered because they hadn’t paid their premiums. Blue Cross, analysts and the government agree is that’s about 15-20 percent of them. Therefore, the actual number of Obamacare enrollees as of March 31 was likely between 6.4 million and 6.8 million, below both the administration’s figure of 8 million and its stated target of 7 million – and definitely not 8 million.
Technology
First, please click on the link to see today’s great comic strip a friend sent my way: Non Sequitur by Wiley Miller shows how R&D really, really works …
Food for thought: Thanks to First Lady Michelle Obama, your child’s nutrition has become even more immersed in nanny government. Here in these United States we have the luxury of being able to to quarrel and quibble over genetic manipulation of food crops then shop and pay extra for “organic,” whatever that definition covers. For other parts of the world, the science that develops genetically modified crops can mean the difference between starvation or health. Last week, for example, the World Food Prize was awarded to crop scientist Sanjaya Rajaram, who has developed 480 disease-resistant varieties of wheat that can adapt to different climates and harsh growing conditions. The $250,000 prize was created by Norman Borlaug, a Nobel Peace Prize laureate, to honor work that improves the quality, quantity or availability of food around the world. Borlaug, who died in 2009, was known as the father of the Green Revolution. Because of his achievements to prevent hunger, famine and misery around the world, it is said that Dr. Borlaug gets credit for having “saved more lives than any other person who has ever lived.”
Social media: Did you know that drug and device makers who send social media messages on services like Twitter will be required to include the risks and benefits of their products when they do so? The Food and Drug Administration proposed that last week in two draft guidelines. Good luck trying to cover it all in Twitter’s 140-character limit after the disclaimer. I mean, have you looked at the fine print on a prescription lately? Source: Bloomberg
Drugs and dollars
Isn’t it curious how you can create a market for a drug? Now that the Centers for Disease Control and Prevention is recommending that everyone born during 1945 through 1965 – the baby boomer group – is tested for hepatitis C, everyone’s working on a cure. Bristol-Myers Squibb Co. has just announced plans to test its experimental antiviral three-drug combination with Gilead Sciences Inc.’s blockbuster drug Sovaldi, hoping to cut treatment time to four weeks. The goal is to cut the cost of Sovaldi’s $84,000 price tag for a 12-week treatment. Officials are concerned that the cost of treating millions of Americans with the progressive liver disease will top $250 billion. About 3.2 million people have chronic hepatitis C in the United States, according to the CDC. Source: Reuters
Speaking of $84,000 drugs: Writing in Forbes.com, John LaMattina notes, “the biggest issue I have is the implication of a ‘powerless’ U.S. population that is being held hostage to big bad pharmaceutical companies.” He points out that in the United States, drug prices can be negotiated; that there will soon be competing medications on the market for hepatitis C, and that physicians are having an impact on drug pricing: Physicians are starting to factor in the costs of drugs in their prescribing practices.
Stem cell success: Stem cell treatment helped Type 2 diabetes patients in a 61-patient trial, according to a study presented at a meeting of the American Diabetes Association. Researchers found that infusions of Mesoblast’s mesenchymal precursor cells had greater reductions in blood sugar levels than those who received a placebo and were well-tolerated. Nearly 26 million Americans are estimated to have diabetes and 7 million of them are walking around undiagnosed, according to the organization. Diabetes contributes to the death of 231,404 Americans annually.
Frontline vaccines:Pfizer’s pneumococcal vaccine line Prevnar topped the list of 10 best-selling vaccines last year, generating sales of $3.974 billion. Merck & Co. and Sanofi Pasteur’s HPV vaccine Gardasil came in second, with sales of $2.122 billion, followed by Sanofi and Sanofi Pasteur’s PENTAct-HIB vaccine with sales of $1.525 billion. Source: Genetic Engineering & Biotechnology News
Biotech bucks: The biotech industry secured more than $4 billion in venture capital investments last year, an 8 percent growth, making it the second-biggest investment sector for venture capitalists for the year, according to Moneytree. That, along with the increasing number of partnerships between large and smaller biotech firms, is expected to help drugmakers “replenish their pipeline” and come up with better products in the future, especially in the areas of oncology, central nervous system diseases, anti-infectives, metabolic diseases, dermatology and cardiovascular diseases. Source: Genetic Engineering & Biotechnology News
Quote of Note
“Nutrition, like health care, is an ever-changing science. Unfortunately, government and big-industry special interests have taken over the messaging of the ‘science’ and, like many science experiments, things can and do go wrong.” – Sarah Wickline
“The bottom line is that the insurance hidden costs, while euphemistically described as cost sharing, serve only as a subtle way to ration care. Faced with a high deductible, many will forgo seeking medical care hoping their problem goes away. If it doesn’t, then the only option is a trip to the emergency room, where by law, care must be provided for any ’emergency medical condition.’ And what a surprise, emergency room visits are increasing since Obamacare took effect.” – Brian Joondeph, MD
