Insurance

August 8, 2018

Shift-and-shaft: Why is it always patients’ burden to hunt for affordable care?

The health policy wonks and those who purport to “reform” the U.S. health care system may be long on academic and other fancy credentials. But they also persist in demonstrating they can be short on old-fashioned common sense, especially about the way most of us lead our lives.

That’s a point emphasized in a recent column in the evidence-based “Upshot” feature of the New York Times, written by Austin Frakt. He directs the Partnered Evidence-Based Policy Resource Center at the VA Boston Healthcare System and is an associate professor with Boston University’s School of Public Health and an adjunct associate professor with the Harvard T.H. Chan School of Public Health.

Frakt looked at some recent research to dissect a question that occupies many experts: Could Americans cut their health care costs by shopping around more for medical services? This is a fond notion held by a slice of health care “reformers,” whom Frankt proceeds to disabuse.

July 31, 2018

Patients? We’re just profitable bit$ and byte$ to Big Pharma and insurers

by Patrick A. Malone

Big Data may be a business buzzword that puts most consumers into a big sleep, but big alarms are sounding for Americans about Big Brother intrusions into their lives via the collection and analysis of vast amounts of highly personal information. Of course, Big Pharma and medical insurers are at the fore of invasive practices — some of which patient-consumers themselves are helping, likely without knowing they’re doing so.

Millions of Americans may be little aware, for example, that they’re now working for GlaxoSmithKline, a global pharmaceutical conglomerate with $9 billion in revenues in just the most recent quarter. GSK just struck a $300-million deal with 23andMe, the company that has persuaded roughly 5 million consumers to spit in a test tube to get a glimpse of their genetic information, notably information about their ancestry and purportedly some of their genomic health risks.

Firms like 23andMe, with promotions at events like Baltimore Ravens pro football games, also have amassed highly personal genetic and medical data on millions of patient-consumers, promising to protect the information but also offering, casually and by the way, that this vital information could be shared — ostensibly for the betterment of public health.

July 20, 2018

When Big Pharma dives for dollars, crises erupt but dire needs go unanswered

by Patrick A. Malone

Americans should be wary lest they get in between Big Pharma and a buck.

That’s what investigators for a U.S. Senate subcommittee showed when scrutinizing how industry middlemen inundated the Show Me State with more than a billion doses of powerful prescription painkillers, making big profits but asking few questions how so many opioid drugs could be taken by so few patients.

It’s also what patients might see as drug makers retreat from research to develop needed new antibiotics and therapies for Alzheimer’s and Parkinson’s.

July 10, 2018

Summer’s discontent: Evidence defies partisans on ACA, Medicaid expansion

by Patrick A. Malone

The evidence accumulates that partisans’ persistent attacks on the Affordable Care Act and Medicaid run counter to their constituents’ needs and wishes, but will Republicans course-correct or will voters soon force them to?

It may be inconvenient in these polarized times for public policy to be rooted in research and fact, rather than bluster and shouting. But the New York Times and Washington Post have posted not one but several stories that raise questions about recent actions by the Trump Administration and the Republican-controlled Congress affecting health care access.

Aaron E. Carroll, a professor of pediatrics at Indiana University School of Medicine and health care policy analyst, wrote for the New York Times’ evidence-based “Upshot” column about research on the ACA-driven expansion of Medicaid. It has prompted publication, he reported of “77 studies, most of them quasi-experimental in design … They include 440 distinct analyses.” Of these works:

July 2, 2018

High-deductible nightmares: the health insurance crisis partisans ignore

by Patrick A. Malone

While political partisans pound without pause for extreme changes in the Affordable Care Act, Medicare, Medicaid, and other government programs that seek to assist the poor, sick, children, and others with access to health care, they’re ignoring the medical nightmare that’s afflicting ever-rising numbers of middle- and upper-class Americans who get their health coverage at work: high-deductible health insurance.

Families long have been staggering under sudden and sizable medical expenses they may be forced to bear because they need health insurance and only can afford their employers’ offerings by reducing their monthly premiums with high-deductible policies. They’re betting they won’t be hit with thousands of dollars in out-of-pocket medical costs.

They’re losing that wager. Often. A lot. And dealing with dire consequences. As Bloomberg News Service reported:

June 28, 2018

No surgery is free of risks or complications, as breast reconstruction study reminds

by Patrick A. Malone

Cancer and surgery — it’s little wonder that even the most resilient patients can buckle a bit when their doctors talk to them about these two issues together and urgently. That’s why new research may be valuable to women with breast cancer, providing them with better evidence-based insight about challenges in their reconstructive options.

The information, which experts said surprised them and may change their views on frequently performed procedures, yet again underscores that surgery can carry significant risks and complications.

In fact, 1 in 3 women who undergo cancer-related breast reconstructive surgery develops a postoperative complication over the next two years, 1 in 5 requires more surgery, and in 1 in 20 of cases, reconstruction fails, the New York Times reported of the published findings of medical researchers, most from the University of Michigan.

June 25, 2018

No summer break for partisans’ extreme attacks on health care access

by Patrick A. Malone

Americans who are poor, middle-class, chronically or mentally ill, disabled, frail, elderly and young — most of us, really — may need to keep our fingers crossed that the relentless attacks on health care access fail again.

Partisans who don’t get the concept of health care as a right have opened many fronts and are especially active of late, with proposed bureaucratic re-alignments of the federal government, promotion of “skinny” or junk health insurance plans, and efforts to slash support for public programs that boost the health of tens of millions through Medicaid, Medicare, food aid, and health coverage for kids of the working poor.

If you’re working and get your health insurance through your job, as most Americans do, you shouldn’t think that you and yours will be magically exempted from Republicans’ hammering at the U.S. health care system.

June 20, 2018

Lasik surgery: a study in medical risks, complications, lack of official followup

by Patrick A. Malone

Caveat emptor, federal officials are reminding patients anew about an eye surgery that tens of millions of Americans already have undergone and all too many may believe ── wrongly ── is all but risk-free.

In fact, significant numbers of the 9.5 million Americans who had laser-assisted operations, the so-called Lasik procedure, may show vision improvements, but they also may be under-reporting problems connected with their surgeries, the New York Times reported.

The federal Food and Drug Administration approved Lasik in the 1990s, but the agency only recently has supported the gold-standard of medical research, a randomized clinical trial, to check in on long-running complaints about the surgery.

June 13, 2018

For early-stage breast cancer patients, dreaded chemo may be unneeded

by Patrick A. Malone

Breast cancer patients may get a welcome respite from one of the disease’s dreaded aspects — its aggressive and costly treatments. New research suggests that thousands of women with early-stage breast cancer who now are told to get chemotherapy don’t need it, while a larger, significant number of patients can benefit by halving the time they’re told to take an expensive drug with harsh side-effects, especially for the heart.

Although this information should be taken in a positive light, patients should consult with their doctors about appropriate treatment for their individual case.

The prospective shifts in breast cancer treatment, based on new findings, may add to rumblings and criticisms about over-treatment and whether doctors have taken too lightly the toll — physically, mentally, and financially — that this and other forms of cancer inflict on patients.

June 11, 2018

Will voters recall what Trump and GOP do on health, not just what they say?

by Patrick A. Malone

As voters make up their minds about this fall’s mid-term races, they may wish to burn into their memories how the Trump Administration has dealt, so far, and especially in recent days, with government social programs that have huge effects on Americans’ health and lives.

Take, for example, the late-week, late night announcement by the U.S. Department of Justice that it will decline to defend yet another part of the Affordable Care Act, as 19 states, most red and led by Texas, attack Obamacare in the courts. The legal aspects of this decision will keep lots of law degree holders and their kindred men and women in black robes arguing, heatedly, for a while. There also may be huge political smoke clouds.

But keep in mind this basic fact from the actions by the Justice Department led by Attorney General Jeff Sessions: The nation’s crack legal team is asserting that it is unconstitutional for the ACA to bar insurers from declining coverage due to preexisting conditions.