Articles Posted in Insurance

hjobs-300x169Although Americans’ spending for prescription drugs has taken a surprising dip, overall costs of medical care keep heading north. The rise this year is faster than it has been in a while. The culprit? Look to big, shiny hospitals. Or look around at people flocking to well-paying jobs in the health care sector.

Modern Healthcare, a trade industry publication, reported that “rising hospital price growth in March [of 2018] drove overall health care price increases to their highest rate since January 2012.”

It’s unclear exactly why hospitals increased prices, except maybe because they can, the magazine said, citing research by the nonprofit health research group Altarum. Its experts, and those quoted by Modern Healthcare, suggested that hospitals may have taken an earlier hit to their finances due to rising drug costs. Hospitals, after lagging, only now may be trying to recoup those costs by hitting patients with price increases at a time when the economy seems more solid.

NORC-chart-300x179Although the United States remains the world’s most affluent nation, it also is a country where money plays a driving, negative role in its people’s well-being. Sudden financial losses  may shorten some Americans’ lives, while dismal finances may keep many others from seeking medical care.

So why are politicians still pushing to slash the nation’s social safety net, even as millions of individuals and families are voting with their wallets to protect their health?

Lethal ‘wealth shocks’

Seroquel-25mg-300x195In a display of just how corruptive big money has gotten to be in modern medicine, Big Pharma keeps getting dubious doctors to write so-called off-label prescriptions for powerful anti-psychotic medications — no matter their proven harm to patients nor big settlements drug makers have been forced to pay.

The Washington Post deserves credit for its investigative dissection of AstraZeneca and its “blockbuster” product, Seroquel (generic name quetiapine). It’s a medication developed to treat severe cases of schizophrenia.

Instead, as has occurred with several other drugs of its kind, doctors — in response to major marketing and sales campaigns by AstraZeneca — have decided this wallop-packing drug can be given for uses for which there is less or little evidence. The Washington Post says doctors write abundant Seroquel scripts for patients with an “expansive array of ills, including insomnia, post-traumatic stress disorder and agitation in patients with dementia.”

FAST-infographic-2016-300x169It’s no April Fool joke: Emergency doctors across the country, according to the New York Times, have been defying widely accepted standards of care and withholding a drug that rigorous clinical trials and medical specialists long have recommended for stroke victims.

Administration of the drug, tPA or tissue plasminogen activator, helps to prevent brain injury after a stroke by dissolving the blood clot and opening up the blocked vessel. Neurologists and neurosurgeons as well as cardiologists, have campaigned for its aggressive use within hours after the onset of symptoms.  Indeed, hospitals nationwide have adopted speedy stroke care, including with tPA, under slogans like “Time is Brain.”

The drug’s fast use has become so accepted, the capacity to administer it is a keystone for hospitals to receive a much-sought designation as specialized stroke treatment centers. And though it has long been thought that tPA needed to be given within three or four hours from the start of stroke symptoms, new research funded by the National Institute of Neurological Disorders and Stroke has opened the strong possibility that many more patients could benefit from tPA and neurosurgery within 16 or even 24 hours after suffering a stroke.

Dumpster-300x251Although enthusiasts still wax on about  how technology will improve lives, patients may want to be wary about purported advances that may end up complicating and even compromising crucial parts of their medical care — including how their medical records are kept and how payers decide if they’re covered.

Let’s start with some kudos for dumpster-diving doctors in Canada who discovered flaws in hospitals’ disposal of supposedly confidential and legally protected patient health records. They went around unidentified facilities collecting from various bins a half ton of paper that doctors, nurses, and hospitals were ready to toss.

After examining the piles of paper, they found most private records had been properly handled. But thousands of documents also were not: They were improperly disposed of, and contained identifying or confidential patient treatment information, the researchers found. Though Canada’s patient privacy laws differ from those in the United States, they agree that patient health records must be guarded, and the researchers found violations of practice, policy, and potentially privacy laws.

medbankruptcy-300x253Illness and accidents batter and beggar Americans worse than many of us realize. New studies show it’s not just the cost of medical services but also long-term care and loss of jobs staggering the lives and finances of too many.

Margot Sanger-Katz, writing in the data-driven New York Times column, “The Upshot,” reported that hospitalization can wreak havoc on Americans older than 50, with many suffering a significant loss in income from which they never recover. This is true, even if they have some financial protection through health insurance. That coverage may soften the blow of medical costs. It doesn’t help them if they can’t return to work, must spend long periods out of work, or must reduce their work hours so they are part-time or less, finds a new study, published in the American Economic Review.

As she wrote:

cnnopioids-300x130Doctors already taking heat for selling out  their prescription pads for financial gain may want to brace themselves for new anger from patients, regulators, and lawmakers over two sets of data detailing unsavory links between MDs’ payments from Big Pharma and their opioid drug prescribing.

CNN, Harvard University, and CareDash.com — a site that says it seeks to serve low- to middle-income patients with reliable health care information — have examined national prescribing data, finding links between Big Pharma pay and doctors’ ordering of prescription painkillers central to a nationwide epidemic of abuse.

CNN, with Harvard, reported its findings:

bloodcells-300x150Soaring prescription drug prices aren’t just an economic or policy-making puzzle, they’re also a constant nightmare for millions of Americans, whether their conditions are common, chronic, or rare.

Or as reporters Katie Thomas and Charles Ornstein wrote recently in the New York Times:

The burden of high drug costs weighs most heavily on the sickest Americans. Drug makers have raised prices on treatments for life-threatening or chronic conditions like multiple sclerosis, diabetes and cancer. In turn, insurers have shifted more of those costs onto consumers. Saddled with high deductibles and other out-of-pocket costs that expose them to a drug’s rising list price, many people are paying thousands of dollars a month merely to survive.

frail-300x150Although patient advocates long have pressed Big Medicine to eliminate unnecessary care — waste in the health care system that some experts estimate adds as much as $765 billion annually in needless costs — it may be past due for a public condemnation of a notably extreme example of this practice: The all too frequent, unhelpful surgeries for the old, many of whom are at the end of life.

Liz Szabo of the independent, nonprofit Kaiser Health News Service, and National Public Radio deserve credit for their report, detailing how 1 in 3 Medicare patients undergoes a serious procedure, “even though the evidence shows that many are more likely to be harmed than to benefit from it.”

As the story explains:

Big Pharma’s notorious middle-men, aka prescription benefit managers or PBMs, are coming under yet more fire — this time over so-called gag orders that they impose on pharmacists they work with, preventing these front-line health care providers from telling patients about cheaper options for drugs.

The New York Times reported that states are leading the push, and soon may be joined by the federal government, to bar companies from preventing this money-saving practice.

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