Health Policy Briefs Compiled by Benita M. Dodd
3D printing to build body parts: Science fiction becomes reality at the Wake Forest Institute for regenerative medicine. Its lab has created the world’s first engineered urethra. First, researchers take a very small piece of tissue from a patient’s bladder. Then, they grow the cells outside the body and put the tailor-made urethra right back in the patient. Doctors were able to give five boys in Mexico who suffered pelvic injuries new urethras. Researchers also are using a printer to create lab-grown ears. So far, it’s worked in animals. A CT scan of the existing ear generates a pattern that scientists replicate. A 3D image is made then layer by layer – the machine prints the ear. Innovation in health care!
Ailing Medicare: Grace-Marie Turner of the Galen Institute, one of the scheduled speakers at the Foundation’s upcoming Georgia Legislative Policy Forum, writes a harsh reminder in National Review Online that Medicare is not sustainable:
“To those who insist that they’ve ‘paid for’ their Medicare benefits and dare politicians to change the program, consider this: A typical couple retiring last year, with both spouses having worked and paid taxes their whole careers, would have paid a total of $149,000 in Medicare taxes. But they are expected to consume an average of $351,000 in medical services in their retirement years (in constant dollars), according to a study from the Urban Institute. That $202,000 gap would have to be financed by higher and higher taxes on fewer and fewer of tomorrow’s workers or by more deficit spending that puts trillions of dollars in debt on the shoulders of our grandchildren.”
Turner maintains that the debate over Medicare is “a microcosm of the larger debate over the role of government in our lives. Voters have a clear choice this election year between two very different visions. Should we entrust government to control and micromanage decisions that impact our lives or should we create new incentives and modernize programs so we can make decisions about our future as adults and free citizens?”
Market-based Medicare: John Goodman’s Health Alert blog says economists writing in the New England Journal of Medicine are proposing two Medicare ideas with merit:
- Give Medicare enrollees the opportunity to enroll in private health plans, with the government paying a fixed sum of money toward the premium.
- Replace the current system of tax subsidies for private health insurance for the working age population with a lump sum, refundable tax credit and make it available regardless of where the insurance is purchased – at work, in the marketplace or in a health insurance exchange.
Still, he says, they could take their proposals further. “For example, we proposed to allow Medicare beneficiaries to add to Medicare’s fee and pay the market price at walk-in clinics and other commercial outlets where prices are clearly market prices, rather than artifacts dictated by the third-party-payer system. Since the alternatives to walk-in clinics are all more expensive, this change would not only expand options for seniors, it would probably save taxpayers money at the same time.” Read more here: http://tinyurl.com/d9ak7dy.
Back so soon? More than 2,000 hospitals will be penalized by the federal government starting in October because many of their Medicare patients are readmitted soon after discharge, new records show. Together, these hospitals will forfeit about $280 million in Medicare funds over the next year as the government begins a wide-ranging push to start paying health care providers based on the quality of care they provide. The 19 percent (nearly 2 million) Medicare patients who return to the hospital within a month of discharge cost Medicare $17.5 billion in additional hospital bills. A total of 278 hospitals nationally will lose the maximum amount allowed under the health law: 1 percent of their base Medicare reimbursements. (Of 108 hospitals evaluated in Georgia, four received the maximum penalty.) Source: Kaiser Health News
Will doctors take Medicaid? About 69 percent of doctors nationally accept new Medicaid patients, but the rate varies widely across the country, according to a study published Monday in the journal Health Affairs. In Georgia, 67.4 percent of doctors accepted new Medicaid patients in 2011. Nationally, 96 percent of physicians accepted new patients in 2011, but rates varied by payment source: 31 percent of physicians were unwilling to accept any new Medicaid patients; 17 percent would not accept new Medicare patients; and 18 percent of physicians would not accept new privately insured patients. Physicians in smaller practices and those in metropolitan areas were less likely than others to accept new Medicaid patients. Higher state Medicaid-to-Medicare fee ratios were correlated with greater acceptance of new Medicaid patients. The findings serve as a useful baseline from which to measure the anticipated impact of Affordable Care Act provisions, which will boost Medicaid rolls. Source: Kaiser Health News
Quote of Note:
“In medicine … we are trying to deliver a range of services to millions of people at a reasonable cost and with a consistent level of quality. Unlike the Cheesecake Factory, we haven’t figured out how. Our costs are soaring, the service is typically mediocre, and the quality is unreliable.” – Dr. Atul Gawande
“There are people who strictly deprive themselves of each and every eatable, drinkable and smokable which has in any way acquired a shady reputation. They pay this price for health. And health is all they get for it. How strange it is. It is like paying out your whole fortune for a cow that has gone dry.” – Mark Twain