The USA has a public health problem with gun violence. This is a pretty hot-button issue, with a lot of differing opinions and differing values. One thing that seems very clear from the data, however, is that the notion that privately-owned guns help prevent gun crime is a myth.
The newly-reported results of the ORBITA clinical trial caught my eye this week. Patients with chronic, stable angina with severe coronary blockages were randomized to angioplasty+stenting vs. ongoing medical therapy alone. Interestingly, the medical therapy patients also received a “sham” cardiac procedure, so the patients were blinded to whether or not they had actually received PCI. There was no significant improvement in angina symptoms with PCI, as measured by exercise duration. Does this mean that the huge number of stents placed annually in the US for angina symptoms is not money well-spent?
Continue reading Health Policy Updates: November 4 2017
The Alexander-Murray bill, a bipartisan compromise to try to stabilize the Obamacare insurance markets, already faced some big hurdles, such as ambiguous support from the White House. This week, an alternative “stabilization” bill emerged, this one entirely Republican, which seems to look a little bit more like Obamacare repeal than simply an insurance market patch.
“Hatch-Brady adds explicitly partisan objectives that Democrats will likely reject: the cuts to the Obamacare mandates and the introduction of anti-abortion restrictions to the CSR payments…Hatch and Brady have now introduced two of the most divisive issues in health policy — the individual mandate and abortion — to the Obamacare stabilization talks. Their plan is more akin to a slightly skinnier version of ‘skinny repeal’ from the summer than an Obamacare stabilization package that both parties would likely support.”
This week, a bipartisan bill emerged to stabilize the ACA insurance market. It remains unclear whether this compromise proposal will enjoy enough support to pass.
“Alexander said the deal he struck with Murray would extend CSR payments for two years and provide states ‘meaningful flexibility’ under the ACA, allowing them to make changes to insurance offerings as long as the plans had ‘comparable affordability,’ which is a slightly looser definition than the existing one…The framework would also allow insurers to offer catastrophic insurance plans to consumers aged 30 and older on ACA exchanges, while maintaining a single risk pool…”
Sarah Kliff at Vox.com gave the shortest, quickest rundown of the different ACA insurance subsidies, and exactly how the recent Trump executive order would change things:
“The Trump administration is not ending insurance subsidies. Instead, they have created a policy where they spend more money to insure fewer people — something you probably won’t see on the president’s Twitter feed.”
Vox.com runs down the recent Trump executive order on health care:
“The ultimate impact will depend on any new regulations written as a result of the order, but overall, the Trump administration could make cheaper plans with skimpier benefits more available — and experts worry that will damage the ACA’s marketplaces.”
More on the White House’s efforts to undermine Obamacare in absence of a Congressional repeal bill:
“But Trump administration officials say that with insurance premiums soaring in many states, consumers should be able to buy less comprehensive, less expensive coverage as an alternative to conventional plans…That has some insurance experts worried. The influx of a set of plans exempt from the Affordable Care Act rules will essentially divide the market and make it increasingly unstable, said Rebecca Owen, a health research actuary with the Society of Actuaries.”
The NYTimes is keeping track of all the ways the White House has been sabotaging the health care law.
Continue reading Health Policy Updates: October 15 2017