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 big news in the world of prescription drug costs – and the economics behind oncology practice – was the White House’s announcement of its exploration into new payment models. The current system has incentives which “may encourage the use of higher-price drugs when lower-cost drugs of equivalent effectiveness are available,” and so the hope is that changing the system may hold down costs and unnecessary treatments. What the new system would look like is not yet clear, as there are many proposals on the table, but the fact that they are moving towards change is significant in and of itself.
“Dr. Patrick H. Conway, a deputy administrator of the Centers for Medicare and Medicaid Services, said the government would test a half-dozen alternative ways of paying for drugs under Part B of Medicare.” Continue reading Health Policy Updates: March 13 2016
You may have heard of the “21th Century Cures Act,” which is winding its way through Congress. If you want a summary of the act, with some opinion on its merits and drawbacks from the physician’s perspective, check out this summary on the Science Based Medicine blog.
“The central question regarding my supporting the 21st Century Cures Act is whether the decent—but not spectacularly so—provisions in the bill outweigh the bad and the ugly. To answer this question, let’s take a closer look. In examining this bill, it is important to note the central assumptions behind the bill.”
If you read one thing this week, read this.
It’s a four-part series in the NYT on why health care prices are so high in the USA, focusing on a different treatment (colonoscopies, prescription drugs, etc) in each part. The length is substantial, but well worth it.
“...payments are often determined in countless negotiations between a doctor, hospital or pharmacy, and an insurer, with the result often depending on their relative negotiating power. Insurers have limited incentive to bargain forcefully, since they can raise premiums to cover costs.”
Economist Tyler Cowen proposes some ideas on the (realistic) potential future of health care reform. One particular idea I hadn’t heard before, but seems to make quite a bit of sense: why not slowly move people from Medicaid onto the exchanges, and eliminate Medicaid entirely?
“One way forward would look like this: Federalize Medicaid, remove its obligations from state budgets altogether and gradually shift people from Medicaid into the health care exchanges and the network of federal insurance subsidies. One benefit would be that private insurance coverage brings better care access than Medicaid, which many doctors are reluctant to accept.”
National Review columnist Reihan Salam responds to the above proposal:
“All that said, Cowen’s bargain is a good starting point for liberals and conservatives, and it’s definitely preferable to the ACA as it stands.”
Wouldn’t this be a good trend to continue? Some insurance companies are starting to target certain preventive treatments and making them low-cost for their customers to try to encourage their usage.
“Aetna now has a list of drugs for which copays have been waived or reduced based on medical literature and the U.S. Preventive Services Task Force (USPSTF) data“