Tag Archives: pharmaceutical industry

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.”


 

Health Policy Updates: January 7 2017

In the big health policy news of the week, the Republican-controlled congress has taken its first – expected – steps towards repealing the ACA/Obamacare by means of the budget reconciliation process.

“The concurrent resolution also establishes a “reserve fund for health care legislation,” which is intended to pocket any savings from repeal for subsequent replacement legislation, as well as a “deficit neutral reserve fund” to revise allocations within the budget resolution and adjustments to the pay-as-you-go ledger in the Senate to ensure that repeal legislation does not violate budget requirements. The reserve fund would allocate $2 billion of savings from the repeal toward reducing the deficit, but hold the rest for eventual replacement legislation.”


Meanwhile, away from the partisan circus of Congress, some leading conservative health policy thinkers are having serious concerns about the repeal-and-delay strategy:

“Antos and Capretta’s piece goes into much more detail on the technical problems of repeal and delay, and is worth reading in full. But they avoid the fundamental issue animating the whole strategy: Republicans don’t know how to replace Obamacare, and they don’t know how to force themselves to figure it out.”

Full details of Joseph Antos’ and James Capretta’s concerns about repeal-and-delay can be found here.

“We do not support this approach to repealing and replacing the ACA because it carries too much risk of unnecessary disruption to the existing insurance arrangements upon which many people are now relying to finance their health services, and because it is unlikely to produce a coherent reform of health care in the United States. The most likely end result of “repeal and delay” would be less secure insurance for many Americans, procrastination by political leaders who will delay taking any proactive steps as long as possible, and ultimately no discernible movement toward a real marketplace for either insurance or medical services.”


Meanwhile, with all the commotion about whether and how to dismantle the ACA, the law itself continue to truck along, providing insurance to some 20 million Americans. Sarah Kliff of Vox.com has some pretty charts showing this.

The uninsured rate is at an all-time low. The federal government announced in September that 8.6 percent of Americans lacked health insurance. That’s a big decline from 2010, when the health care law passed and the uninsured rate was 16 percent.”


In some local North Carolina health policy news, incoming governor Roy Cooper has announced plans to expand Medicaid in the state. Don Taylor of Duke shares his thoughts on how this may play out.


From Aaron Carroll at The Incidental Economist, in which the adjective “crazypants” is used to describe US health care spending.

“Between 1996 and 2013, more than $30 trillion was spent on personal health care. Let that sink in for a minute or two. Over that time period, spending increased between 3% and 4% annually for most age groups.”


The prices for drugs are going up. A lot. And not just in cancer, as I’ve written about many times, but for multiple sclerosis as well.


The 21st Century Cures act that President Obama just signed into law, which both funded the cancer “Moonshot” and weakened FDA regulatory power, is not universally loved. Drs. Aaron Kesselheim and Jerry Avorn share their thoughts in this JAMA commentary.

“Among the most concerning sections of the new law are components that address the types of data that manufacturers will be able to use to gain FDA approval of new products or additional indications for existing products…When biomarkers used as the basis for drug approval are not rigorously validated, they may not actually predict patient benefit, can mislead physicians about whether a drug works, and have the potential to expose patients to poorly effective treatments or unanticipated adverse effects.”


 

 

 

Health Policy Updates: November 12 2016

There has been immediate hypothesizing about the future of Obamacare given the election result. Sarah Kliff at Vox.com expects that full repeal is a real possibility, and emphasizes that his “replacement” plan would lead to an additional 21 million uninsured Americans.

“In broad terms, Trump’s plan looks a lot like the dozen or so other Republican Obamacare repeal plans that have come out over the past few years. Trumpcare allows insurance companies to go back to refusing coverage for preexisting conditions, a key barrier to coverage before Obamacare’s coverage expansion. The plan would, according to outside analysts, increase the number of uninsured Americans by 21 million people.”

Health Affairs’ Timothy Jost gets into the weeds of the ACA’s different components, and discusses which can still effectively be reversed and which have already become too ingrained to undo.

“Immediate repeal of the ACA and presumably restoring the law that preceded it would likely bring the Medicare program, for example, to a halt until new rules could be written. The ACA is inextricably interwoven into our health care system and is not going away immediately.”

Continue reading Health Policy Updates: November 12 2016