Articles Posted in Health Care Reform

cagovlogo-300x106Although President Trump has made California a favored object of scorn, the Golden State has put itself on a path to help patients better rein in Big Pharma price gouging on prescription drugs in a way that Washington hasn’t. California lawmakers have given the green light for the state to leap into making generic drugs, notably  affordable insulin to assist diabetics.

The state legislative season ended with a bill, advancing to Gov. Gavin Newsom for his signature by Sept. 30. The bill orders California’s top health agencies by January to partner with existing makers to develop and produce generics and biosimilars. As the Los Angeles Times reported of the California pharmaceuticals plan detailed in SB-852:

“Under the measure, state-developed generics would be ‘widely’ available to public and private purchasers within California. Taxpayers would pick up the costs — roughly $1 million to $2 million in startup funding, plus ongoing staff costs estimated in the low hundreds of thousands of dollars annually, according to a state fiscal analysis. It’s unclear which drugs the state would make or procure, though it would target drugs that could produce the biggest cost savings for the state and consumers.

ssalogo-150x150Health care persists as one of the top concerns for voters as they consider candidates this fall — not just for the presidency but up and down the ballot.

A lot got said at the political conventions in the last two weeks on the topic, and, to their credit, media organizations have engaged medicaidnu-300x151in fact-checking and myth-busting  about health-related topics.

But beyond the crafted speeches over four nights for each party and looming past the repeated talking points of the candidates and their hand-picked supporters, voters will confront issues of huge gravity — some well known and others maybe less so.

acavote-300x200In the middle of a pandemic with a novel virus that has infected at least 2.5 million Americans and killed roughly 127,000, and with 20 million people jobless, what is a prime Republican response? They are advancing yet again a court case to strip tens of millions of poor, working poor, and middle-class Americans of  health insurance.

By the way, when doing so — by seeking a total repeal of the Affordable Care Act — the Trump Administration and a collection of states led by Republican attorneys general also would put at huge risk key health insurance safeguards that Americans embrace, including:

  • They no longer would be guaranteed the protection of insurers denying them coverage based on pre-existing conditions.

covidclosedstore-300x200Wall Street investors may be seeing their portfolios flush again. But the Covid-19 pandemic has left tens of millions of Americans jobless. And if the once-flourishing health care business has not snapped back into rosy condition as it so often has in difficult times, the battle of the last decade over health insurance will haunt patients and employers throughout the coronavirus infection.

The New York Times reported that record-setting, sudden unemployment has exposed the perils to workers of their reliance on health insurance they get via their jobs:

“While hospitals and doctors across the country say many patients are still shunning their services out of fear of contagion — especially with new [Covid-19] cases spiking — Americans who lost their jobs or have a significant drop in income during the pandemic are now citing costs as the overriding reason they do not seek the health care they need. ‘We are seeing the financial pressure hit,’ said Dr. Bijoy Telivala, a cancer specialist in Jacksonville, Fla. ‘This is a real worry,’ he added, explaining that people are weighing putting food on the table against their need for care. ‘You don’t want a 5-year-old going hungry.

amputate-300x157Although the Covid-19 pandemic may be opening more and more Americans’ eyes to the harsh effects of the country’s economic and racial inequities, the stark damage from the nation’s health disparities can be plain to see — in truly disheartening ways.

Lizzie Presser, a reporter for the Pulitzer Prize-winning investigative site ProPublica, deserves high praise for her distressing article on “The Black Amputation Epidemic.” As she wrote recently from deep in the poverty, neglect, and racial discrimination of the Mississippi Delta:

“[W]ithin months, the new coronavirus would sweep the United States, killing tens of thousands of people, a disproportionately high number of them black and diabetic. They were at a disadvantage, put at risk by an array of factors, from unequal health care access to racist biases to cuts in public health funding. These elements have long driven disparities, particularly across the South. One of the clearest ways to see them is by tracking who suffers diabetic amputations, which are, by one measure, the most preventable surgery in the country.

magazines-199x300For those who may have more time on their hands due to the pandemic and who may be seeking deeper digs into Covid-19, excellent long-form coverage is abounding.

Consider, for example, taking time for the New Yorker article by  Siddhartha Mukherjee, a cancer doctor, biologist, and best-selling nonfiction author who delves into the question of “What the coronavirus crisis reveals about American medicine.”

His premise includes in its painful illumination a quote from Warren Buffet, the Oracle of Omaha, whose quip assumes a different poignancy when applied to the post-pandemic state of medicine:  “When the tide goes out, you discover who has been swimming naked.”

ACAsigning-300x176As the coronavirus pandemic causes Americans sky-high anxiety about their health and how they might access and afford extensive medical treatment if infected, the nation slid with only modest public attention into the second decade of one of its landmark health care experiments — the Affordable Care Act.

Obamacare became the law of the land on March 23, 2010, when the 45th president signed the 2,000-page bill for which he had campaigned long and hard. Republicans in the White House and Congress have attacked the ACA relentlessly ever since.

Researchers have spent a decade scrutinizing the ambitious act’s outcomes with zeal. The New York Times summarized some of the independent, nonpartisan evaluations, finding key areas that the public may wish to recognize in how Obamacare changed the complex U.S. health care system, on which Americans spend more than $3.5 trillion annually. In brief, as a result of the ACA, the newspaper reported (with boldface emphases mine):

hhslogo2-150x150The Trump Administration, to its credit, has put out finalized new rules that aim to give patients greater access to and use of their all-important medical records, now mostly captured and contained in electronic form.

Federal officials had to battle a handful of wealthy, powerful corporations that own and install proprietary software and computing systems to try to help patients.

They also instantly created major new concerns with their “interoperability” regulations for doctors and hospitals:

acapopularpoll-300x168Timing may be everything in life and the law: The U.S. Supreme Court — while giving the Trump Administration a small political break for now — may give the president’s fall reelection campaign plenty of upset still. Whether the court will give the country a health care disaster is another question.

The high court, acting on a request by Democratic state attorneys general, has agreed once more to consider the fate of the Affordable Care Act, aka Obamacare, on an expedited basis, even before a federal trial court and appellate judges finish their consideration of the latest legal challenge to the ACA.

This will be the third time the justices have taken up an ACA lawsuit, with this challenge representing not only  another Republican attack on government-assisted health insurance for the poor, working poor, and middle class. This also may be a legal extreme for questioning Obamacare, as the New York Times reported:

Budget-300x156President Trump’s 2021 budget proposal is thicker than an old-fashioned phone book. Lots of the document became little more than chaff the instant it was printed, due to the likelihood of big changes in the spending plan by congressional Democrats and lawmakers of the president’s own party.

The fiscal wish list, unsurprising at its contents were, may raise a big political question: How, with evidence like this, does the leader of the free world campaign on a counter-factual argument that his policies and practices protect and advance the health of the American people — a prime concern, pollsters say, of the voting public?

The $4.8 trillion Trump budget, for example, proposes to slash the Medicaid and food stamp programs by $1 trillion over a decade, with presidential critics noting the various, sometimes bureaucratic means to do so, ultimately, will reduce desperately needed social supports and throw millions of vulnerable Americans off aids for their health care. (Federal courts, including the appellate panel overseeing Arkansas, have rejected the latest way the administration and GOP states have sought to reduce Medicaid costs by imposing draconian work, reporting, and qualifying rules.)

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