Checking Up On Health: August 17, 2016

Health Policy News and Views
Compiled by Benita M. Dodd



Trucks line up on the Ambassador Bridge to cross from Detroit into Canada.

Trucks line up on the Ambassador Bridge to cross from Detroit into Canada.

I visited Canada briefly over the weekend, driving into Windsor, Ontario, from Detroit. Did you know? The first eatery visible after you cross the Ambassador Bridge into Canada is a McDonald’s; the second is a Popeye’s!

What was really interesting, however, was the proliferation of pharmacies in Windsor. I assume — I can’t vouch for it — that it’s as a convenience for U.S. citizens who want to zip over there to purchase Canada’s lower-priced prescription drugs. That began a discussion in the car about why Canada drugs are cheaper: lower prices because of the government’s buying power there as opposed to private negotiations in the United States, fewer choices provided and the fact that other countries don’t have to eat the costs of research and development, for example.

But I came across something else today that could also explain why U.S. prices are so much higher: our litigious society. Again, I can’t vouch for it. I was reading about the proliferation lawsuits involving Johnson and Johnson’s talcum baby powder. It’s unfathomable to me that two woman can win $127 million against the company, claiming baby powder caused their ovarian cancer. A Los Angeles Times article notes The Ovarian Cancer National Alliance doesn’t even list talc as a risk factor.

For decades, millions upon millions of adults and babies around the world, including me and mine, have used this product without ill effect. Now there are more than 1,200 lawsuits filed, and last month attorneys filed a motion seeking class action status.

And that’s not even a prescription drug. The cost of litigation has to be  written into the cost of doing business and, just like shoplifting, raises the price of products for the rest of us. (FYI, one report put the 2014 cost of retail “shrink” — shoplifting, employee or supplier fraud and administrative errors — at $403 per household.)


Shrinking choices: If you’re with Aetna in an ObamaCare exchange, you probably need to find new insurance for 2017. The company is dropping in 70 percent of the counties and 11 of the 15 states in which it currently operates. It will continue offering certain plans in Delaware, Iowa, Nebraska and Virginia. Aetna reported a second-quarter pre-tax loss of $200 million on its individual health care plans. (That total includes results from insurance offered outside of the Obamacare exchanges.) There is some speculation Aetna’s move is partially motivated by the federal government’s challenge to Aetna’s planned merger with Humana. Nevertheless, Aetna isn’t the first to pull out of ObamaCare. As expected, the plans attracted too many high-cost, sick people and not enough healthy participants, whose premiums are necessary to help cover the cost. The low penalties for skipping coverage provide little incentive for healthy participants to sign up. Georgia is losing both Aetna and UnitedHealth; five insurers are expected to offer ObamaCare plans in 2017.

Rising prices: The average premium for the average lowest-cost medium-benefits plan for a 40-year-old nonsmoker is expected to increase 9 percent in 2017, hitting a monthly payment of $281, according to Kaiser Family Foundation. 

Smoking gun: Premium surcharges for smokers in ObamaCare health plans not only haven’t succeeded in getting them to quit, they have discouraged some smokers from getting insurance in the first place, according to the journal Health Affairs. While plans offered on the exchanges established by the Affordable Care Act (ACA) cover smoking cessation treatment with no cost sharing, they also charge tobacco users up to 50 percent more in premiums than non-users. And the government may now include vaping under the “tobacco use” definition. Vaping, which is safer, has been a gateway to cessation for millions of smokers. Source: American Enterprise Institute


There’s an app for that: Becker’s Hospital Review lists 50 health care apps for clinicians and consumers to know. Among them: Doctor on Demand, a $40, pay-per-visit telemedicine model that offers consultations via computer or smartphone as well as 25- and 50-minute psychology sessions.  But my favorite is Everseat (Baltimore), which allows providers to fill open slots in their schedules and notify patients when more desirable slots open up.

Cost of care: How much will you need to save for your health care in retirement? According to Fidelity’s Retirement Health Care Cost Estimate, a couple who retired in 2015 at age 65 can expect to spend an estimated $245,000. That’s a 29 percent increase since 2005, when it was $190,000 (see chart). The increase is based on longer life expectancies and anticipated annual increases for medical and prescription expenses. 


Glass houses and drugs: The Olympics are winding down in Brazil. Some athletes lost their spot before they even got there after testing positive for performance-enhancing drugs. While American swimmer Lilly King’s calling out of Russian competitor Yulia Efimova took center stage, CNN warns that (American) people in glass houses should be careful of throwing stones. The United States has had its fair share of doping scandals, and some labs created performance-enhancing designer drugs, Samuel Chi writes.   

Timing is everything: Pregnant women may need to skip the Tylenol for those aches and pains now in order to avoid headaches later. A new British study reports that using acetaminophen, especially during the third trimester (32 weeks) of pregnancy, was associated with a higher risk of conduct disorders, emotional problems and problems with hyperactivity when children were 7 years old. The authors suggest timing might be important, with prior research also showing stronger associations between risk of behavioral problems and maternal acetaminophen use in the third trimester, as opposed to the second trimester. “Given that there is active brain development and growth during the third trimester, this finding could indicate that there are developmental periods when the brain is more sensitive to acetaminophen exposure,” they wrote. Source: MedPage Today


DASH from gout: People with hyperuricemia (gout) were significantly helped by following the blood-pressure-lowering DASH diet showed significant decreases in serum urate levels, according to an “influential randomized study,” MedPage Today reports. Participants who adhered to the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes the consumption of vegetables, fruits and low-fat dairy foods as well as whole grains, poultry, fish and nuts, saw their serum urate levels of decrease, researchers reported in Arthritis & Rheumatology.
About gout:  This painful rheumatic condition is caused by a buildup of uric acid crystals in the joints. The most common form of inflammatory arthritis in men, it normally flares in the base joint of the big toe and can last for weeks. It can be caused by obesity, insulin resistance, metabolic syndrome, hypertension, congestive heart failure, alcohol intake (beer and spirits more than wine), diuretic use, a diet rich in meat and seafood, and poor kidney function. According to the Centers for Disease Control and Prevention about 4 percent of American adults and about 6 percent of men have gout.

In brief

Telemedicine talk: Georgia’s Dr. Jeffrey English talked recently to the Heartland Institute about how telemedicine takes physicians to their patients. Listen here.

Data breach: Athens (Ga.) Orthopedic Clinic says it can’t afford to offer free credit and identity monitoring to the 200,000 people who may have been affected by a data breach, the Athens Banner-Herald reports.

Benita Dodd is vice president of the Georgia Public Policy Foundation.