Health Policy Briefs
Compiled by Benita M. Dodd
N.C. says no to Medicaid expansion: North Carolina Gov. Pat McCrory is backing a move by the Legislature to block the state from expanding its Medicaid program or participating in the state health insurance exchanges created by the Federal Affordable Care Act. In a news release today, McCrory made the point, “In light of recent Medicaid audits, the current system in North Carolina is broken and not ready to expand without great risk to the taxpayers and to the delivery of existing services to those in need. We must first fix and reform the current system.” The state will also not create an exchange, but will leave it to the federal government. Friday is the deadline for states to declare whether they want to partner with the government in the exchange. Georgia Governor Nathan Deal has already announced he will not expand Georgia’s Medicaid rolls or implement a state exchange.
Whoops: The Obama administration has delayed until 2015 the rollout of a health program aimed at low to moderate-income people who won’t qualify for the expanded Medicaid program under the federal health law, ObamaCare, Kaiser Health News reports. Under the so-called Basic Health Program, some states had planned to offer government insurance to people who don’t qualify for Medicaid, but who would be hard pressed, even with federal subsidies, to afford the plans offered in the new insurance exchanges. The Department of Health and Human Services said last week it ran out of time to put out guidelines to get the program running by 2014.
Raising the ceiling: Individuals who buy their own health insurance will see the total amount they could pay out of pocket for medical care capped starting next year, but some are expected to pay higher premiums as a result, according to Kaiser Health News. A new study shows that more than one-third of health insurance plans currently offered to individual buyers exceed the federal health law’s maximum annual consumer spending cap. Starting next year, the Patient Protection and Affordable Care Act law sets a limit of about $6,300 in out-of-pocket costs – about double that for family coverage. The law also requires insurers to count the annual deductible – the amount consumers pay before insurance kicks in – toward that maximum, something that the study by HealthPocket found many plans do not do. Currently, when deductibles are included, 36 percent of policies offered to individuals on the private market exceed that limit, according to the study.
Before you know it: Scientists now believe that Alzheimer’s begins at least a decade before symptoms appear. The Food and Drug Administration has released guidelines that may make it easier for drug companies to test Alzheimer’s treatments in people at an earlier stage – before the onset of brain damage and memory loss – when scientists think they may have the best shot at working. The need for new treatments is great and growing: A study released last week suggests that the number of Americans with Alzheimer’s disease could triple to 13.8 million by 2050. Meanwhile, just three drugs have been approved since 1998, while 101 candidates have failed. Source: Reuters
Need a reprint? One day, you may be able to take living cells, load them into a printer and squirt out a 3D tissue that could develop into a kidney or a heart. Researchers from the University of Edinburgh report that they have created a cell printer that spits out living embryonic stem cells. The printer was capable of printing uniform-size droplets of cells gently enough to keep the cells alive and maintain their ability to develop into different cell types. The new printing method could be used to make 3D human tissues for testing new drugs, grow organs, or ultimately print cells directly inside the body, according to LiveScience.com.
Bestsellers:The top three best-selling drugs of the 21st century are Advair (for asthma), Plavix (blood thinner) and Lipitor (for high cholesterol), according to Genetic Engineering and Biotechnology News. But do you know the top 10 biopharma clinical trial failures of 2012? Among them were trials of treatments for Alzheimer’s, Hepatitis C, coronary heart disease, depression, schizophrenia, kidney disease, and breast and prostate cancer.
Government accounting? Health and Human Services Secretary Kathleen Sebelius said for every dollar spent on fraud and abuse in the past three years, the government brought $7.90 back in through lawsuits and fines. The government reported it recovered $4.2 billion in health care fraud money in 2012. One wonders, however, what counts in “every dollar spent.”
The need for transparency: Just 16 percent of hospitals in a recent survey gave a complete price quote for a common hip surgery, highlighting the obstacles many patients face in comparison shopping, according to a study in the Journal of the American Medical Assn. for Internal Medicine. The price quotes varied considerably, from $11,100 to $125,798 for the same hip surgery. The study said Medicare and large insurers often pay $10,000 to $25,000 for joint replacement surgery. Source: Los Angeles Times
Quotes of Note
“The greatest healing therapy is friendship and love.” – Hubert H. Humphrey
“He’s the best physician that knows the worthlessness of the most medicines.” – Benjamin Franklin