Tag Archives: pharmaceutical industry

Health Policy Updates: August 19 2017

What would it take to make the US health care system the best in the world? We already spend more money (by far) on health care than any other country, but our results are middling (see the figure below). Recent thoughts on what the US might do in order to translate our huge financial investment in health into better results, in the NEJM.

“The first challenge the U.S. health care system must confront is lack of access to health care…Affordable and comprehensive insurance coverage is fundamental. If people are uninsured, some delay seeking care, some of those end up with serious health problems, and some of them die.

The second challenge is the relative underinvestment in primary care in the United States as compared with other countries…In contrast to the United States, a higher percentage of these countries’ professional workforce is dedicated to primary care than to specialty care, and they enable delivery of a wider range of services at first contact…”  Continue reading Health Policy Updates: August 19 2017

Health Policy Updates: July 29 2017

As of Tuesday, the Senate voted to open debate on a bill which, 24 hours prior, its members did not know the contents of.

“…there are at least four different draft health care bills floating around right now…The lack of clarity is part of a larger lack of direction for Senate Republicans’ six-month health care effort…Throughout this process, Republicans have struggled to articulate what exactly they want to achieve — aside from delivering on a seven-year campaign promise to repeal and replace Obamacare.”

Votes on the BCRA and then “full” Obamacare repeal followed shortly thereafter, and were both defeated by slim margins. Attention then turned to the so-called “skinny repeal,” which would leave the ACA/Obamacare’s Medicaid expansion intact and get rid of only the individual and employer mandates to have health insurance. Finally, even skinny repeal went down in a vote early Friday morning, with John McCain breaking party ranks (and joining Sens. Collins and Murkowski) to become the decisive “no” vote, in a dramatic fashion on the Senate floor – video here.

It remains to be seen whether the ACA repeal effort is truly dead this time, or will continue to rise from its own ashes.
Continue reading Health Policy Updates: July 29 2017

Health Policy Updates: April 22 2017

Like a phoenix rising from its own ashes, Republican health care reform is alive again. Vox.com’s Sarah Kliff runs through some of the features of the new version of their bill:

“What we do know is that this latest proposal doesn’t do much at all to assuage concerns about the older proposals. While it meets many of the demands of the party’s far-right wing — namely, the deregulation of the individual insurance market — it does nothing to address concerns about massive coverage loss. Instead, it likely makes those problems worse…

…This GOP amendment to let states waive community rating would once again allow insurers to charge people based on their expected health care costs. Insurers would not be able to deny coverage to people with preexisting conditions, but they would have free rein to charge them especially high premiums.”

President Trump demonstrated his expertise in the complex details of health policy, with his analysis of the changes to this new version of the health care reform bill:

“‘The plan gets better and better and better, and it’s gotten really, really good, and a lot of people are liking it a lot,’ Mr. Trump said.”

Continue reading Health Policy Updates: April 22 2017

Health Policy Updates: February 18 2017

It hasn’t been a good week for Obamacare. More insurers are pulling out, and the Trump Administration seems to be split on whether it wants the exchanges to die now or hang around a little longer to provide for a smooth transition.

“The administration’s zigzags haven’t placated worried insurers, who see another year of red ink from enrollees that are older and sicker than they had expected. Congress’ paralysis on repeal and replacement translates into precisely the kind of uncertainly that makes risk-averse insurers want to run for cover. And Trump’s executive order, signed just hours after his inauguration, unnerved the health plans with its call for government agencies to abolish as much of the law as possible through administrative action. That fueled fears that his administration won’t enforce the individual mandate requiring most Americans to get coverage.”

Continue reading Health Policy Updates: February 18 2017

Health Policy Updates: January 21 2017

News surfaced this week raising serious conflict-of-interest and corruption concerns regarding Trump’s nominee to head the department of Health and Human Services, Tom Price. It seems that he bought shares in a device manufacturer immediately before introducing legislation to protect reimbursement for the use of such devices, maintaining demand for the company’s products.

“After Price offered his bill to provide Zimmer Biomet and other companies relief from the CMS regulation, the company’s political action committee donated to the congressman’s reelection campaign…The issue has become a major liability for the congressman after The Wall Street Journal reported last month that he traded roughly $300,000 in shares over the past four years in health companies while pursuing legislation that could impact them.”


Margot Sanger-Katz of the NYTimes walks through exactly what the ACA/Obamacare does, which provisions are likely to go or stay if repeal happens, and what that would mean.

“When Republicans talk about repealing Obamacare, they tend to focus on the parts of the law that expanded insurance coverage and regulated health insurance products, not these ancillary parts. That means that portions of the Affordable Care Act that people don’t associate with the word “Obamacare” are likely to endure.”


Donald Trump continues to double-down on promises to “cover everyone” with his health insurance plan, and also drastically lower drug prices. This is in contrast to the leading Republican plans for ACA replacement, which do neither of these things.

“The objectives of broadening access to insurance and lowering health-care costs have always been in conflict, and it remains unclear how the plan that the incoming administration is designing — or ones that will emerge on Capitol Hill — would address that tension.”


The Congressional Budget Office has run the numbers on Obamacare repeal and found that it would add an additional 23 million Americans to the uninsured roles over the next 10 years. Will whatever “replacement” plan that ends up surfacing be able to make up that difference?

“The agency put up a blog post that said it won’t let Republicans count especially skimpy coverage as health insurance. It argued that health insurance needs to provide ‘financial protection against high medical costs’ for CBO to count the people who buy it as covered. Republicans hadn’t even submitted a replacement plan yet, at least not publicly. So it seems notable that CBO proactively decided to go ahead and lay down the ground rules for scoring in a very public way.”


A slew of papers came out in JAMA journals last week, focusing on the issue of conflicts of interest in medicine. Propublica summarizes.

“‘The very way we all think about disease — and the best ways to research, define, prevent, and treat it — is being subtly distorted because so many of the ostensibly independent players, including patient advocacy groups, are largely singing tunes acceptable to companies seeking to maximize markets for drugs and devices,’ researchers Ray Moynihan and Lisa Bero wrote in an accompanying commentary.”