Checking Up On Health: April 30, 2013

Benita Dodd  Vice President  Georgia Public Policy Foundation
Benita Dodd
Vice President
Georgia Public Policy Foundation

Health Policy News and Views
Compiled by Benita M. Dodd

Hospital care spending: Georgia is second only to Utah in a ranking of the states with the lowest hospital care spending per person, according to the Kaiser Family Foundation. Utah spends $1,830 per person, while Georgia spends $1,922 per person. Alaska is the biggest spender, at $3,879 per person for hospital care. The figures are from 2009, the latest year available. Hospital care includes all services provided by hospitals to patients, such as room and board, ancillary charges and all other services billed by hospitals. Click here to see the list. Interestingly, at $4,948 per person, the District of Columbia far outspends all the states; the U.S. average is $2,475 per capita.

Georgia-specific data and the need for a solution: The Kaiser Family Foundation’s breakdown of Georgia health care data includes some interesting tidbits. One Georgian in five had no health insurance in 2010-2011, compared with the U.S. average of 16 percent uninsured. It reports that 1,963,601 Georgians received food stamps – 20 percent of the population. In 2010-2011, 14 percent of Georgians were on Medicaid and 13 percent of Georgians were on Medicare. With 207,653 children enrolled in PeachCare, the state’s CHIP, Georgia ranked fifth in the nation in June 2011. All this helps explain the need for quality, creative, innovative and cost-effective solutions for the state. Read  Kelly McCutchen’s innovative proposals for Georgia to cover the uninsured here:  

Health care pricing transparency: Pricing and quality-of-care data are crucial to consumer-driven health care. Patients deserve to be able to compare both in making informed decisions with their health care dollars and with their lives. A report by Catalyst for Payment Reform and the Health Care Incentives Improvement Institute quantifies ranks the states on health care price transparency laws. The two groups graded each state on whether health care pricing information is available, how accessible it is and the scope of information available. Overall, 29 states received an “F” grade, and seven states received “D” grades, meaning an overwhelming majority of states do not offer consumers adequate information on health care prices. Only Massachusetts and New Hampshire earned an “A” for having met several criteria, including: sharing information about the price of services for both inpatient and outpatient services; sharing price information for both doctors and hospitals; sharing data on a public website and in public reports; and allowing patients to request information prior to a hospital admission. “F” grades went to Georgia and all its neighbors except Florida, which earned a “D.” Source: Health Care Incentives Improvement Institute  

Telemedicine, the tractor of health care: The Affordable Care Act is the culmination of a health care reform discussion that focuses on access to insurance coverage, instead of access to medical care, according to Atlanta physician Dr. Jeffrey Grossman. He points out in a commentary published by the Institute for HealthCare Consumerism that, “The most well-insured person with a maxed-out health savings account who is involved in a car wreck in rural Georgia is unlikely to have access to a neurosurgeon due to a lack of trauma centers. Yet an uninsured person who sustains a gunshot wound to the head in Atlanta and is taken to the trauma center at Grady Memorial Hospital could very possibly have access to the renowned Dr. Sanjay Gupta.” Telemedicine is a technology that can help, but is not being properly leveraged because, “telemedicine regulations are determined by each state, and lawmakers decide what constitutes the establishment of a physician-patient relationship and minimum standards of care. … For example, Hawaii is progressive while Georgia is in flux. This is why one of the leaders in telemedicine, Teladoc, is available in some states and not others. These fences need to come down.” We concur. 

Cancer medicines that cost more than $100,000 a year aren’t morally justifiable and may keep patients from getting life-saving treatments, according to a group of more than 100 leukemia doctors. Of the 12 cancer medications approved by the Food and Drug Administration last year, 11 cost more than $100,000 annually, the physicians wrote in an article in Blood, the journal of the American Society of Hematology, published online and reported by Bloomberg Businessweek. Drug makers counter that there are programs available for patients who can’t afford the expensive treatments. One wonders how much costly government overregulation contributes to the high prices and how morally justifiable that is to ailing patients. …

Individualized treatments coming to a hospital near you: Major medical centers across the U.S. are investing in genomic sequencing in the race to bring precision medicine to the clinic, according to The New York Times. These institutions see a future in “precision medicine,” analyzing patients’ genomic data to find better cancer therapies. By investing in infrastructure, the medical centers could help discover breakthrough drugs that cure patients and return financial rewards.The Times says they are “spending and recruiting heavily in what has become an arms race within the war on cancer.”

Quick Picks:

Remember P.J. O’Rourke’s oft-quoted comment? “If you think health care is expensive now, just wait until it’s free!” The amount of the average subsidy per enrollee in the health care exchanges under ObamaCare, for example. According to the Congressional Budget Office, by 2023 it will be $8,290 per individual.

No more banned drugs. The Economic Times of India reports that the health ministry plans to suspend the sale of medicines when they are banned in one of the six major global drug markets for harmful side-effects. In the future, if international regulators ban a drug in the United States, United Kingdom, Canada, Japan, European Union or Australia, its sales will be stopped in India until clinical data can show that it will not have adverse effect on patients in the country.

Improving the odds: The five-year survival rate for non-Hodgkin lymphoma was 40 percent in the early 1960s, and the rate for leukemia was 14 percent. By the last decade, those rates had climbed respectively to 86 percent and 57 percent, thanks to improvements in treatment. PhRMA reports that there are 241 drugs in the pipeline to treat blood cancers. 

Quotes of Note 

“For so long, the health care system, in a sense, worked in the shadows. Consumers had no skin in the game, and almost behind a curtain, the transaction was somehow settled upon. Cost was not a critical issue … Consumers are much more engaged in health care now due to the economic climate and [mechanisms] such as high-deductible health plans, and they have to manage care in a more proactive way.” – Robin Gelburd, president of FAIR Health

“Government interventions over the past four decades have yielded a cascade of perverse incentives, bureaucratic diktats, and economic pressures that together are forcing doctors to sacrifice their independent professional medical judgment, and their integrity. The consequence is clear: Many doctors from my generation are exiting the field. Others are seeing their private practices threatened with bankruptcy, or are giving up their autonomy for the life of a shift-working hospital employee. Governments and hospital administrators hold all the power, while doctors – and worse still, patients – hold none.” – Dr. Jeffrey A. Singer

“I don’t want to get to the end of my life and find that I have just lived the length of it. I want to have lived the width of it as well.” – Diane Ackerman, American author, poet and naturalist

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