Health Care Reform Category Archives — DC Medical Malpractice & Patient Safety Blog Published by Washington, D.C. Personal Injury Lawyers

August 26, 2022

Listen up: Lower-cost hearing aids, finally, are an option for millions without a prescription

Is it time for a glimmer of optimism about reducing at least one unacceptably high health care cost?

Say hear, hear then, to the federal Food and Drug Administration’s removing the last regulatory block to consumers with mild to moderate hearing loss buying cheaper, easier to access, over-the-counter (OTC) hearing aids — potentially as soon as this fall.

Hearing some fading Bronx cheers? Those may be for the regulators who plodded to potentially benefit tens of millions of folks, who were forking over $5,000 for pairs of medically prescribed devices that previously also required expensive attention of doctors and audiologists. Patients also were ripped for the costs of this care, which typically was not covered by traditional insurance or Medicare. As the Washington Post reported of the regulatory shift to allow OTC hearing devices:

August 17, 2022

Rollout will take time for Democrats’ big act on health, climate and taxes

by Patrick A. Malone

President Biden and congressional Democrats have embarked on a major political experiment, testing the public’s willingness to delay gratification on seeing big benefits of a landmark measure with important elements to improve their health and wellbeing.

Is it more persuasive to regular folks that one political party is trying to tackle huge problems, or will relentless naysayers reap rewards for doing little or nothing?

As a little more than four score days remain before important midterm elections, Democrats will be seeking to convince voters of the significance of the giant Inflation Reduction Act — aka the much-reduced Build Back Better legislative package originally proposed by President Biden.

July 26, 2022

Big shakeups under way in much-criticized U.S. health agencies

by Patrick A. Malone

While most regular folks wouldn’t give a hill of beans about the organization of bureaucracies in Washington, D.C., frustrated taxpayers should be taking note of seismic rumblings about restructurings that are shaking some of the biggest, most powerful, and influential federal health agencies.

Biden Administration officials, in one of their notable moves, have announced that responses to pandemics and other public health crises will be led now by a separate, independent division within the sprawling Health and Human Services agency.

While officials hastened to say that the 1,000-person Office of the Assistant Secretary for Preparedness and Response, or ASPR, will work hand-in-glove with the federal Centers for Disease Control and Prevention, the CDC clearly is taking its lumps for the shambolic course it took, starting in the previous administration, in dealing with the coronavirus pandemic.

July 17, 2022

As medical costs, especially for cancer, slam patients, where’s Congress?

by Patrick A. Malone

While Congress seems paralyzed or, at best, willing to shrink significantly its efforts to help Americans deal with the punishing costs of care in the U.S. medical system, could federal lawmakers be confronted at the same time with more compelling evidence about the need for aggressive, not timid, action?

Do beleaguered constituents need to barrage members of the House and Senate with copies of an excellent, painful series from NPR and the nonpartisan Kaiser Health News service on the crushing effects of medical debt on regular folks, especially cancer patients? Must voters write, call, and email representatives to ensure they see the research findings of the Kaiser Family Foundation or the Commonwealth Fund about how nightmarish the U.S. medical system has become?

In detailing the “financial toxicity” that cancer patients experience with bankrupting treatment, KHN reporter Noam Levey mixes poignant human stories with scary economic data to detail how care for a leading killer of Americans may have improved medically but has become a calamity of a different sort. He makes these points among others (quoted liberally but without their sourcing, not fully included in these bullets for brevity’s sake):

July 5, 2022

Health insurers start to join hospitals in giant disclosure of data on prices

by Patrick A. Malone

If patients can benefit from price transparency by hospitals, shouldn’t employers and health insurers post online what they are paying for medical services? Yes, say federal regulators, who started requiring this effective July 1.

The federal Centers for Medicare and Medicaid Services (CMS) has ordered parties that act as health payers to make public a wealth of economic information that previously had been closely held, NPR and the Kaiser Health News service reported:

“[H]ealth insurers and self-insured employers must post on websites just about every price they’ve negotiated with providers for health care services, item by item. About the only exclusion is the prices paid for prescription drugs, except those administered in hospitals or doctors’ offices. The federally required data release could affect future prices or even how employers contract for health care. Many will see for the first time how well their insurers are doing compared with others. The new rules are far broader than those that went into effect last year requiring hospitals to post their negotiated rates for the public to see. Now insurers must post the amounts paid for ‘every physician in network, every hospital, every surgery center, every nursing facility,’ said Jeffrey Leibach, a partner at the consulting firm Guidehouse.”

July 3, 2022

Senators kill big plan to modernize VA care but offer no alternatives

by Patrick A. Malone

One of the nation’s largest health care systems had its ambitious plans to reshape itself for the 21^st century torpedoed by a dozen members of the U.S. Senate, with taxpayers and veterans left in the lurch with great uncertainty about the future medical care for those who valiantly have served this country.

Just a few weeks ago, Denis McDonough, the secretary of the Department of Veterans Affairs (shown right), met a deadline from Congress to detail significant shifts in how his sprawling agency cares for former military personnel and their families.

He provided a proposal — a plan only — to shut many of the VA’s 1,200 big, aging hospitals and clinics or slash services there, shifting to smaller facilities, and refocusing the agency’s caregiving to parts of the country where its patients live. His plans and the future of VA care, which already have been under study for at least four years, were then to be taken up by a blue-ribbon group, the Asset and Infrastructure Review (AIR) Commission. The commission then would have reported back to Congress for possible action.

June 17, 2022

U.S. hits hospitals with a million reasons to heed price-disclosure rule

by Patrick A. Malone

Federal officials will fine two Georgia hospitals, both in the same health system, a total of more than $1 million for failing to post online legally required pricing information. Patient advocates and the former administration hoped this incremental disclosure would help check ever-rising health care costs and give consumers important data to make better choices about which institutions they chose for treatment.

But hospitals nationwide, including the penalized Northside Hospital Atlanta (shown above) and Northside Hospital Cherokee, have flouted the transparency regulation that took force in January 2021. The Centers for Medicare and Medicaid Services (CMS) has wagged a warning finger at institutions, issuing cautions to hundreds of institutions, with hundreds deciding to fall in line. Still, as the Washington Post reported:

“Out of more than 5,200 hospitals, just about 6% had both an accessible file and a shoppable display that adhered to the regulations. That’s according to a research piece published [June 6] in [the Journal of the American Medical Association, which] analyzed compliance six- to nine-months after the rules went into effect. Other reports found a similar pattern. In February, a report by patient advocates determined that a total of 14% of the 1,000 hospitals the group reviewed were in line with the requirements.”

May 29, 2022

An advanced democracy can’t shrug at mass deaths, especially kid killings

by Patrick A. Malone

Experts fear the country is veering dangerously into a widespread acceptance of mass death as just a regular part of life — not only by moving on with little more than faint acknowledgement of more than 1 million coronavirus pandemic fatalities but also with a tragic resignation about fatal shootings at schools, groceries, movie theaters, and other public places.

It has been chilling to watch the “new normal” of the public reactions to a racist shooting that killed 10 in a Buffalo, N.Y., grocery, and the slaughter of 19 children and two adults at an elementary school in Uvalde, Texas with destructive disinformation spreading, public officials fatally bungling, and political partisanship calcifying apace.

Most Americans recognized that the coronavirus was the worst health threat to the global community in a century. Most of us listened to experienced, evidence-based experts and followed their recommendations to quell the disease. But Republicans, with their White House running a shambolic, counter factual pandemic response, quickly politicized the efforts to battle the disease, experts say, and that helped bring about hundreds of thousands of preventable deaths.

April 15, 2022

Nursing homes in desperate need of giant overhaul, experts say

by Patrick A. Malone

The nation’s nursing homes and other long-term care facilities are in dire need of drastic overhaul to dramatically improve the quality and safety of their treatment of the aged, sick, and disabled. They too often now get what one expert has described as “ineffective, inefficient, inequitable, fragmented, and unsustainable” care.

To repair the glaring, longstanding wrongs in these facilities — problems that critics say contributed to 150,000 resident deaths during the coronavirus pandemic — requires sweeping practical, regulatory, and financial changes in an industry focused on profits and resistant to change, according to newly published expert research report by the National Academies of Sciences, Engineering, and Medicine.

The academies, with members who are leaders in their fields, are private, nonprofit institutions that work outside of government to provide objective advice on matters of science, technology, and health.

April 6, 2022

Big Pharma donates big to GOP lawmakers as drug costs keep rising

by Patrick A. Malone

While regular folks howl about the need to slash skyrocketing prescription drug costs, Big Pharma is showering lawmakers on Capitol Hill with campaign contributions and favoring Republicans in the House and Senate who show political promise — and an aversion to efforts to ensure the affordability of medications for the sick.

The crushing costs of drugs has returned to the policy-making spotlight as Democrats in the House, with a few defecting Republicans, have approved a bill to limit the soaring price of insulin to $35 a month for most Americans who have insurance and whose health and lives depend on the increasingly unaffordable medication. As the New York Times reported:

“To become law, the bill will need to attract at least 10 Republican votes in the Senate to overcome a filibuster. Some lawmakers involved in the effort have expressed optimism that such a coalition might be possible, but few Republican senators have publicly endorsed the bill yet. Senator Susan Collins, Republican of Maine, has been working with Senator Jeanne Shaheen, Democrat of New Hampshire, on a broader bill related to insulin prices. The bill would have substantial benefits for many of the nearly 30 million Americans who live with diabetes. Insulin, a lifesaving drug that is typically taken daily, has grown increasingly expensive in recent years, and many diabetes patients ration their medicines or discontinue them because of the cost. About one in five Americans who take insulin would save money under the proposal, according to a recent analysis from the Kaiser Family Foundation.