Articles Posted in Health Care Reform

newmitch-300x176After weeks of huddling in partisan secrecy, majority Republicans in the U.S. Senate have coughed up what they’ve dubbed the Better Care Reconciliation Act , aka their version of Trumpcare.

In brief, the GOP Senate bill would:

  • Slash Medicaid, faster and more than the House version, aka the American Health Care Act

mitch-300x226bernieBernie Sanders recently offered on Twitter what he described as a display of all the Senate Republicans’ public considerations of the American Health Care Act, aka Trumpcare: a photo of a blank piece of paper.

Not a bad jibe, and a window into the deepening bipartisan dismay that Majority Leader Mitch McConnell and his  Republicans soon will try to jam through the next step in their long-sought effort to repeal and replace the Affordable Care Act, aka Obamacare.

Does McConnell have the 50 votes he needs so Vice President Pence can break a Senate tie and move Trumpcare closer to reality? Will this occur in just days, before Congress heads to its July Fourth recess? Or will it happen in the small period before the long August recess, when Trump Administration officials also want Congress to take up an increase in the debt ceiling and to tackle a budget and maybe some tax law changes?

actemraBig Pharma and medical device makers have opened their wallets for a 2017 lobbying spree, throwing  tens of millions of dollars around the nation’s capital, including to campaign with lawmakers and regulators to defend their soaring prices and to speed the path for their products to get to markets. But credit’s due to officials and organizations like Stat, the online health information site, for building a greater urgency behind a different narrative: It may be as crucial to monitor and regulate drugs and medical devices after they’re publicly available as pre-approval.

A two-part Stat report, aptly titled “Failure to warn,” dismantles existing oversight of prescription medications, especially regulators deeply flawed, big-data driven initiative dubbed Sentinel. The eight-year-old, $207 million program is supposed to mine insurance records to surface side-effects of drugs recently approved by the federal Food and Drug Administration.

But by examining 500,000 reports of side-effects from drugs targeted at the 1.5 million Americans with debilitating rheumatoid arthritis, Stat shows Sentinel’s shortcomings with Roche’s billion-dollar RA product Actemra. The FDA has received 1, 128 reports, complaining about patients who have died while taking it. But the agency, Stat says, “doesn’t have sophisticated tools to determine whether the drug was a culprit or a bystander in those deaths.”

girls-300x208It isn’t a teary topic fit only for moody young adult fiction and sudsy afternoon TV dramas: Depression afflicts as many as a third of girls, becoming a rising problem for some as early as age 11 and increasingly separating out as gender difference in the mental health between boys and girls.

The higher incidence of depression in girls—found in interview research with more than 100,000 young participants from 2009 to 2014 in the annual, statistically representative National Survey of Drug Use and Health—has raised concern among mental health experts. They note that depression can cause patients to struggle with relationships and school. It can lead some to suicide and may require sustained treatment for those with more serious cases.

Researchers could not explain why girls are more affected by depression, and they were surprised to find the earlier gender divergence, with it occurring at younger ages than had been tracked before. This tends to undercut existing psychological theories, they said, that depression in girls may be triggered by hormone changes or other significant life shifts that occur in their teens.

mitchPresident Trump and the Republican-controlled Congress haven’t repealed the Affordable Care Act. Yet.

Still, analyses show how, as one critic said, the GOP plans a big move of federal money from “health to wealth”—to take support from the poor and middle class, especially from the very voters who put Trump in office, to finance a $1 trillion tax cut for the rich, Big Pharma, medical device makers, and, yes, operators of tanning salons.

There’s been a huge amount of press coverage, but look at some key health care numbers—from the nonpartisan Congressional Budget Office, the White House, and health policy experts— and see if this motivates you to get in touch with your elected officials:

Tom_Price_official_Transition_portrait-150x150Chris_Collins_113th_Congress-150x150Chuck_Flieschmann_Official_Portrait_112th_Congress-150x150Patty_Murray_official_portrait_113th_Congress-150x150
Sheldon_Whitehouse_2010-1-150x150

Photos:  Sen. Sheldon Whitehouse,  Sen. Patty Murray,  Rep. Chuck Fleischmann,  Rep. Chris Collins, HHS Secty. Tom Price

The U.S. Congress, based on its members’ legally required financial disclosures, fares far better than most. Senators and representatives are worth a net $1 million on average. But is it seemly for so many of our crucial voices in the nation’s capital to be enriching themselves even more, with some trading stocks in areas—like health care—in which they also are legislating?

Politico, the website devoted to politics, deserves credit for digging into 21,300 stock trades lawmakers made in the last two years. Reporters found that 384 of the nation’s 535 members of the House and Senate had zero such activity. But a handful of lawmakers accounted for hefty dealing, with Mike McCaul, a Texas House Republican, racking up more than 7,000 trades.

Donald_Trump-1-225x300The Trump Administration raised major weekend alarms among some of the biggest players in health care with the president’s reported willingness to try a risky gambit by cutting off crucial federal subsidies to help millions of poorer Americans afford health insurance. Some in the GOP see the move forcing opponents to endorse the American Health Care Act, aka Trumpcare. But critics say it will cost millions their coverage and blow up existing insurance exchanges.

Politico, the website devoted to political coverage, reported that President Trump told his top advisers that he wants to cut off for this year $7 billion that Uncle Sam pays to insurers to reduce deductibles and other out-of-pocket costs so an estimated 7 million poorer Americans can afford health coverage on exchanges set up under the Affordable Care Act, aka Obamacare.

Trump is said to think this draconian move will push Democrats to negotiate with the GOP to support Trumpcare. But opponents say it not only will wreck ACA health insurance exchanges, causing insurers to flee losses from participating in them, it will not save money. It will force Uncle Sam to pay $2.3 billion more in other related ACA costs, notably some tax credits.

nih_header-300x72Although its battles over health insurance have dominated the headlines, Congress also provided a glimmer of good news on funding for medical research. Lawmakers, at least for this fiscal year, shunned President Trump’s request to slash the budget of the National Institutes of Health. Instead of giving it the billion-dollar haircut the Administration sought, Congress boosted the NIH budget by $2 billion for the five months left in the current fiscal year.

The added fiscal support will be a boon for important research on: cancer, Alzheimer’s, precision medicine, the brain, and the battle against superbugs.

I’ve written how Congress earlier had, with much fanfare, decided to set aside partisan concerns to provide a steady increase in medical science research, which has been budget starved for some time. But the president had demanded cuts across the board, particularly so he could hike the appropriations for areas like the military and homeland security—notably his much promised border wall with Mexico.

It’s up to the U.S. Senate now whether tens of millions of Americans get stripped of the health insurance they obtained under the Affordable Care Act, aka Obamacare, or what kind of coverage they might have under some version of  the American Health Care Act aka Trumpcare.

News organizations have posted some good, factual summaries of Trumpcare vs. Obamacare, as passed by the House last week, including here and here and here. The Congressional Budget Office, the federal outfit that is supposed to provide lawmakers a nonpartisan, independent analysis of the costs and effects of legislation, will score the House bill sometime this week so Americans really know what the bill does and how much it costs.

jobs-300x229Soaring medical costs are bad for our economic health, so why isn’t someone doing more about them?

There’s a reason, hiding in plain sight,  contends Chad Terhune, a seasoned health care journalist. He wrote a revealing Op-Ed in the New York Times, pointing out that 1 in 9 Americans now works in health care, up from 1 in 12 in 2000. Look around the country: Hospitals are throwing up fancy new buildings and putting to work tens of millions, many in some seriously high-paying jobs. As Terhune has noted:

Thirty-five percent of the nation’s job growth has come from health care since the recession hit in late 2007, the single biggest sector for job creation. Hiring rose even more as coverage expanded in 2014 under the health care law and new federal dollars flowed in. The law gave hospitals, universities and companies even more reason to invest in new facilities and staff. Training programs sprang up to fill the growing job pool. Cities welcomed the development — and the revenue. Simply put, rising health spending has been good for some economically distressed parts of the country, many of which voted for Mr. Trump last year.

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