Health Policy News and Views
Compiled by Benita M. Dodd
Even Dems are abandoning ship: The landmark health-reform law passed in 2010 has never been very popular and always highly partisan, but a new Washington Post-ABC News poll finds that a group of once loyal Democrats has been steadily turning against ObamaCare: Democrats who are ideologically moderate or conservative. Just after the law was passed in 2010, 74 percent of moderate and conservative Democrats supported the federal law making changes to the health-care system. But just 46 percent express support in the new poll, down 11 points in the past year. Liberal Democrats, by contrast, have continued to support the law at very high levels – 78 percent in the latest survey. Among the public at large, 42 percent support and 49 percent oppose the law, retreating from an even split at 47 percent apiece last July. Source: Washington Post
Emergency room use isn’t going away: Once government required everyone to be insured, millions of Americans would find a primary care physician instead of using the emergency room, the proponents of ObamaCare said, thereby improving their health and lowering medical costs. Except, according to the Journal Health Affairs, for lower-income people the hospital emergency room is their default health care provider. The Health Affairs study concedes that being uninsured and underinsured plays a role, it points out, “But even in countries with near-universal health insurance coverage, low-value use persists among low-SES (socioeconomic status) patients. This suggests that factors beyond insurance shape preferences for inpatient versus ambulatory care.” Among them, doctors’ offices tend to be open during normal business hours and low-income workers often have jobs that don’t give them the flexibility to leave during the day; they tend to be paid by the hour, so taking time off to go to the doctor may reduce their income; they tend to be younger, and on average healthier, than the population. People who rarely need to see a doctor may feel little impetus to find a regular care provider. And many doctors won’t take new Medicaid patients, whereas the hospital will. ObamaCare will not reduce emergency room care use; in fact, it may even increase. Low income is a big determiner of who will use the emergency room, and that problem has been rising under the president’s economic policies, the Institute for Policy Innovation points out. IPI Resident Scholar Merrill Matthews notes, “Because Obama was more concerned about passing a health care bill than fixing the health care system, ObamaCare defenders used arguments they thought would make the sale – even if they were wrong.”
Now everyone’s a doctor: It seems physicians are fighting a losing battle with self-diagnosing patients who find their symptoms in alarming maladies on the Internet. Doctors sometimes must deal with patients swho how up armed with a scary list of unlikely ailments, demanding expensive and unnecessary tests. It can also be dangerous for patients if they fail to seek expert medical advice for a problem after mistakenly concluding they don’t need a doctor. To combat that, The Wall Street Journal reports, more health-care providers are steering patients to new and improved computerized symptom-checkers that make it easier for them to get reliable information about possible diagnoses, research their condition and even connect directly to a doctor. Source: Wall Street Journal
Now and later: Beginning in January 2014 under the Patient Protection and Affordable Care Act (PPACA), insurers will no longer be able to use gender and health status to set premiums and will be restricted in the
amount they can vary premiums based on age and tobacco use, among other provisions. As a result, beginning in 2014, the way insurers may calculate base premiums prior to underwriting may change. Today, the Government Accountability Office released a new report on the states’ January 2013 range of premiums offered to consumers in the individual market. Displayed on the HealthCare.gov Plan Finder, they reflect insurers’ base premiums prior to underwriting. It looked at ranges for six different types of consumers: 1) 30-year-old, single, nonsmoking male; 2) 30-year-old, single, smoking male; 3) 30-year-old, single, nonsmoking female; 4) 30-year-old, single, smoking female; 5) a family of four with two parents, aged 40; and 6) a couple aged 55. It’s going to be interesting to see how this range changes under ObamaCare.
Who’s at risk, who’s not: For-profit and nonprofit hospitals face growing risks to their bottom lines over the next several years as they complete the transition under ObamaCare from a fee-for-service system to a value-based payment system, according to a report from Moody’s Investors Service. Moody’s said small, nonprofit, standalone hospitals “will be at greater risk” for financial troubles under these reimbursement models. “Hospitals will be in danger of eroding profits as they straddle two types of reimbursement systems: the current model, which incentivizes healthcare providers to use more services, and new models that emphasize value,” said Diana Lee, Moody’s vice president and senior credit officer, in a news release. The report also said medical device companies stand to lose the most in the shift to value-based care, as hospitals and health insurers are looking to reduce admissions and procedure volumes — the lifeblood of medical device companies’ success. Health insurers are positioned to benefit the most, Moody’s said, because they will now be able to share more financial risks with providers.
Health care jobs: Slightly more than half — 51 percent — of health care employers plan to hire full-time workers in the next six months of the year, according to CareerBuilder and MiracleWorkers.com’s most recent national survey. Additionally, 34 percent of employers plan to hire part-time employees, up from 28 percent in 2012, and 27 percent plan to hire temporary or contract workers, up from 12 percent last year. The survey results include responses from more than 200 healthcare hiring managers and human resources professionals. Source: Becker’s Hospital Review
Age reversal? Researchers have found a key new role for a protein called BMI1 that may help scientists develop tissues to replace damaged organs in the human body. The discovery suggests that manipulating BMI1, along with other regulatory molecules, might one day be among the steps included in molecular recipes to turn specialized cell development on and off to create new cell-based treatments for tissues lost to injury, disease or aging, researchers say.
Starve a cancer: Researchers have found a new treatment to kill cancer cells but leave the body’s healthy cells undamaged, unlike traditional therapies such as radiotherapy. Researchers at the University of Southampton (England) said that the cancer cells grow and divide much more rapidly than normal cells, meaning they have a much higher demand for and are often starved of, nutrients and oxygen. A cellular component known as eEF2K plays a critical role in allowing cancer cells to survive nutrient starvation, while normal, healthy cells do not usually require eEF2K in order to survive. Researchers say that by blocking the function of eEF2K, they should be able to kill cancer cells,without harming normal, healthy cells in the process.
‘New’ immunosuppressant: The Food and Drug Adminstration has approved a once-daily immunosuppressant for organ rejection in kidney transplant patients. Astellas Pharma’s new organ rejection drug Astagraf XL is an extended-release version of the Japanese drugmaker’s off-patent Prograf (tacrolimus). An Astellas official said the approval of Astagraf XL “marks an important milestone in post-transplant care as it provides physicians with a new treatment option.” Astellas has been selling once-daily tacrolimus as Advagraf in the European Union since 2007 and in Japan as Graceptor since 2008. Source: Pharmatimes.com
Quotes of Note:
“We hear so much about patient-centered care, and I have no doubt for some people and organizations that is really their mission. But viewing the patient as the main person you report to puts things in a different light.” – Chuck Lauer
“A healthy attitude is contagious but don’t wait to catch it from others. Be a carrier.” – Tom Stoppard