I am giving my highest recommendation to Elizabeth Rosenthal’s new book on health care costs, An American Sickness. It was her reporting at the NYTimes several years ago that first got me interested in understanding (and controlling) the high costs of medical care that we have in this country.
Equally highly recommended is her interview with Terry Gross on NPR’s Fresh Air.
“What you see often now is when generic drugs come out … the price doesn’t go down to 20 percent of the branded price, it maybe goes down to 90 percent of the branded price. So we’re not getting what we should get from a really competitive market where we, the consumers, are making those choices.”
Continue reading Health Policy Updates: April 15 2017
With the prices of many new specialty pharmaceuticals skyrocketing, the number of patients qualifying for Medicare’s “catastrophic” prescription drug provision is skyrocketing as well.
“Experts say the rapid rise in spending for pricey drugs threatens to make the popular prescription benefit financially unsustainable. Nonpartisan congressional advisers at the Medicare Payment Advisory Commission have called for an overhaul. The presidential candidates, as well as the Obama administration, have proposed giving Medicare legal authority to negotiate prices.”
Continue reading Health Policy Updates: July 31 2016
A very detailed, and very good, piece in Politico about the ongoing cost problem facing the ACA/Obamacare. Fewer young and healthy people have signed up than anticipated, leaving the average costs higher for everyone else. As a result, insurance companies are losing money, and are raising their prices to try to catch up. Trends like this are concerning that we may be seeing the early stages of a “death spiral,” in which prices continue to rise higher than more and more people are able to afford.
I found this article to cover both the successes and the problems of the ACA in a fair and comprehensive way, and recommend it highly.
“A close look at what’s really keeping the exchanges underwater suggests that some of the problems are self-inflicted wounds by Obama and his administration; others are the handiwork of Republican saboteurs, who undercut the safeguards intended to help companies weather the uncertainty of the new law…None of the problems are insurmountable, but if they aren’t fixed, the law could find itself in a mounting crisis—what observers call a “death spiral”—in which competition vanishes, costs skyrocket, and a dwindling pool of insurers offer policies so expensive that health insurance is as out of reach as it ever was.” Continue reading Health Policy Updates: July 24 2016
The United States Preventive Services Task Force came out with a recommendation against PSA screening for prostate cancer several years ago. While adherence to this guideline certainly isn’t 100%, it looks like it is starting to have some effect.
“The study found that 30.8 percent of men ages 50 or older reported getting the PSA test in 2013, down from 37.8 percent in 2010 and 40.6 percent in 2008. It also found that the rate of prostate cancer diagnoses in that age group fell from 534.9 per 100,000 in 2005 to 416.2 in 2012.” Continue reading Health Policy Updates: November 21 2015
The Institute of Medicine just came out with another one of its monstrously-sized, influential reports last week, this one entitled “Dying in America.” Here is a very positive review of the report (and of palliative care in general) by MD and former leading Republican senator Bill Frist:
“The secret to these cost savings and improved outcomes is that palliative care moves the locus of care to the home. Palliative care is patient-centered and delivers care where the patient is most comfortable resulting in better outcomes while at the same time being more cost effective.”
The number of proton beam accelerators is increasing, even in the absence of evidence that they do much to improve outcomes. Are insurers starting to push back?
“The use of proton beam therapy has accelerated rapidly in recent years as medical centers have raced to capitalize on its clinical and financial potential. At the same time, those efforts have drawn increasing criticism from some consumer and health care advocates who suggest that the therapy is a clear illustration of how new technology can drive costs higher for consumers and insurers without necessarily improving care.”
On media coverage of the ACA:
“This is the problem in the debate about Obamacare. The two sides live in different informational universes.”
On of my favorite science podcasts, Science Friday, took a departure from standard “science” topics last week for a discussion with a surgeon about money in health care. The discussion touches on a lot of the same issues of price transparency, perverse financial incentives, etc. that keep popping up on this listserve.
On the Forbes blog, “concierge medicine” is proposed as a solution for increasing demands in primary care:
“As a direct pay practice, I do not contract with insurance of any kind. The fact is, I have no incentive to order anything my patients do not need. By keeping my overhead low, I can charge a fraction of the cost of a traditional doctor visit. This also allows me to see 10 people per day, and thus, spend more time with each person.”