Checking Up On Health: April 15, 2014

News and Views on Health Policy
Compiled by Benita M. Dodd


It’s Tax Day; your ObamaCare grace period is “over:” Today is the “final” day to sign up for health insurance in the federal exchange. It’s the end of the beyond-the-deadline 15-day grace period for those who “experienced delays,” AKA the extension to allow more people to sign up. According to the White House, more than 500 million “7.5 million people” have signed up for the exchanges, with “400,000 applications” coming in after the official deadline of March 31. People who sign up by today will have health coverage beginning May 1. Those who still do not have insurance must pay a $95 fee or 1 percent of their income, whichever is higher. No telling how those “covered” will do on health care and access, however.

Health Care Forum May 7: At its May 7-9 Forum at the Galleria Centre, the Institute for Healthcare Consumerism hosts the first face-to-face “Great Debate” between two of the nation’s most influential health care experts on the future of health reform in the United States: John Goodman, a key thought leader for free market solutions and Dr. Kenneth Thorpe, who worked in the Clinton administration on “HillaryCare” and has been key resource to most every Democratic presidential nominee during the last 20 years. Find out more about the May 7-9 conference at the Galleria Centre in Cobb County.

For a special price of $159, Foundation members can attend the events of Wednesday, May 7. This includes a four-hour pre-conference presentation, “Physicians Report on State of Health Care in America,” by Docs 4 Patient Care; the Great Debate and the Opening Night Reception. Find out more at

Heart help: It was with great sadness that metro Atlantans heard of the death last weekend of “Captain” Herb Emory, WSB’s traffic reporter extraordinaire, as the result of a massive heart attack. I don’t know whether he had a history of heart disease, but I read with interest in Yahoo Health about the simple, widely available tests, one costing just $15, that could help prevent heart attack deaths. A study in the journal Heart is reported to be the first to show that an electrocardiogram (ECG) administered in the ambulance is associated with improved survival after a heart.

The study included nearly half a million heart attack patients admitted to hospitals in England and Wales. People who received an ECG in the ambulance had significantly lower 30-day death rates, compared to those who did not receive the test. In the United States, however, only about 25 percent of such patients get an ECG in the ambulance.

You had one job: This is such egregiously gross misconduct, I can’t even begin to express my outrage. The Macon Telegraph reports that a radiology technician at Georgia’s Perry Hospital was expected to enter a negotiated plea agreement today, accused of improperly entering negative results for 1,289 mammograms in 2009 and 2010 that were not read by a radiologist. Of those, 10 that Rachael Michelle Rapraeger entered as negative were actually positive, prosecutors have said. At least two of the women named as victims in the indictment have since died. The charges? Forgery and misdemeanor reckless conduct.

Politicians and physicians: The government released data last week showing how much more than 888,000 physicians received in Medicare Part B payments in 2012. It’s the first time such information has been made publicly available in about 35 years. According to The New York Times, several of the largest Medicare recipients were huge donors to political causes, contributing hundreds of thousands of dollars to political action committees and/or campaigns. “One could infer that the physicians were protecting particular reimbursements,” says Becker’s Hospital Review in an article titled, “Medicare Releases Billing Records: 10 Quick Obervations.” On the other hand, The Washington Post interviewed the five of the physicians who got the most and reported, “A clear trend emerges from the data and from interviews with these physicians: The high cost of drugs is a huge driver of the robust Medicare payouts.” A little more than half of the Medicare payments to the 10 physicians, or $61.9 million, went toward drugs and “other costs.” Several physicians said their charges actually represent those of an entire practice, company or department.

Shots or pills? Merck’s grass pollen allergy pill Grastek got federal approval this week, becoming the second such immunotherapy treatment to be given the go-ahead in recent weeks. Previously, immunotherapy was available only through shots. Unlike antihistamines, which tackle symptoms, immunotherapies work by boosting the body’s immune system and making it less sensitive to allergens. The company expects to launch the drug, approved for patients age 5 to 65, in the United States by late April. Grastek is placed under the tongue and dissolves. Earlier this month, the FDA approved Stallergenes’ immunotherapy treatment for five types of grass pollen. Source: Reuters

Is this you? A Canadian study published in the Annals of Internal Medicine suggests that about one third of new prescriptions (written by primary care physicians) are never filled. Over 15,000 patients were followed from 2006 to 2009. Prescription and patient characteristics were analyzed, though patients were not directly interviewed about their rationale for not filling their prescriptions.

In short, patients were less likely to fill a prescription if the treatment was expensive, but certain types of drug indications had consistently higher non-fill rates:

  • headache (51% not filled)
  • ischemic heart disease (51.3% not filled)
  • thyroid agents (49.4% not filled)
  • depression (36.8% not filled) 

As far as those prescriptions more likely to be filled, antibiotics (especially for urinary tract infections) ranked number one. Source: 

International innovators: The International Partnership for Innovative Healthcare Delivery has named the most promising world health care innovators of the year, and they include a chain of diabetes management clinics in Mexico, a scratch off code to reduce drug counterfeiting in developing countries and a company brokering loans to family members of patients in need of surgery in India. Aside from recognizing these leaders, the partnership’s goal is reverse innovation, or taking innovations from developing nations and replicating them in developed nations. “Many of the most promising innovations in healthcare delivery are emerging in developing countries. This makes sense because necessity is the mother of invention,” says Andréa Taylor, the partnership’s research program manager. Source: Becker’s Hospital Review 

Growing body parts: Researchers at University College London have grown body parts such as noses, ears, blood vessels, tear ducts and windpipes using stem cells. The team uses polymer scaffolds and stem cells that are taken from patients’ fat and grown in the lab. Source: Associated Press 


From foundations to government: Sylvia Burwell, who will replace Kathleen Sebelius as Health and Human Services Secretary, came from the world of foundations before joining the Obama adminstration to head the Office of Management and Budget. Before her most recent appointment, the Rhodes Scholar was president of the Walmart Foundation, which she joined in 2012. Before then, she was president of the Global Development Program at the Bill & Melinda Gates Foundation. She worked with the Gates Foundation for 10 years, and was also its first COO.  Find out more from Becker’s Hospital Review here.

Hope … and change: So you wanted to compare insurance before and after the Affordable Care Act? Good luck with that. The Census Bureau, the authoritative source of health insurance data for more than three decades, is changing its annual survey so thoroughly that it will be difficult to measure the effects of President Obama’s health care law in the next report, due this fall, census officials said. The changes are “intended to improve the accuracy of the survey,” according to The New York Times. But the new questions are so different that the findings will not be comparable, the officials said. Why the change? The questionnaire traditionally used by the Census Bureau provides an “inflated estimate of the uninsured” and is prone to “measurement errors,” said a working paper by statisticians and demographers at the agency. Erm, what? As The Federalist reports, do you know what else is due this fall? Elections.

Quotes of Note

“The White House says it’s surpassed its goal for people enrolled in ObamaCare. It’s amazing what you can achieve when you make something mandatory and fine people if they don’t do it, and keep extending the deadline for months.” – Jimmy Fallon



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