Archive for September, 2012

Today’s Headlines – Sept. 28, 2012

Today’s early morning highlights from the major news organizations, including reports about political and policy-oriented health care developments.

The Washington Post: Medicare Working To Boost Obama In Swing States, Poll Finds
Voters in three critical swing states broadly oppose the far-reaching changes to Medicare -associated with the Republican presidential ticket and, by big margins, prefer President Obama to handle the issue, according to new state polls by The Washington Post and the Kaiser Family Foundation. For seniors in Florida, Ohio and Virginia, Medicare rivals the economy as a top voting issue (Aizenman, Cohen and Craighill, 9/27).

The Associated Press/Washington Post: Looking Past Entitlements, Senior Voters Ask How They Will Fare In An Obama Or Romney Economy
Get in line, Medicare and Social Security. Seniors, like just about everyone else, have money on their minds. Who wins the trust of seniors … will be a deciding factor in the presidential election. That should be good news for Mitt Romney, because those 65 and older have backed the Republican candidate in both of the last two presidential elections. But President Barack Obama has been pounding Romney and his running mate, Rep. Paul Ryan, on their plan for Medicare. Those attacks are starting to bear fruit for Obama, who is gaining ground among seniors in two key battlegrounds: Florida and Ohio. Still, Romney has the edge nationally among seniors — in no small part thanks to seniors’ concerns about Obama’s handling of the economy (9/27).

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Friday, September 28th, 2012

Study: States, Feds Recover Billions In Medicaid Drug Fraud Settlements

Eager for revenues, states are settling more cases than ever — and at record amounts — with drug makers accused of defrauding Medicaid programs, according to a new analysis from the consumer group Public Citizen.

In just the first half of 2012, the federal government and states have recovered $6.6 billion, according to the report. Overcharging health programs, mainly in the form of drug pricing fraud in state Medicaid programs, was the most common violation during the study period, from Nov. 2, 2010 through July 18 of this year.  Unlawful promotion of drugs was associated with the largest penalties.

Seventy-four settlements totaling $10.2 billion in financial penalties were reached between federal and state governments and pharmaceutical manufacturers during the study period. Three companies – GlaxoSmithKline, Johnson & Johnson and Abbott – accounted for two-thirds of the financial penalties paid to federal and state governments, according to the report. GlaxoSmithKline alone paid out $3.1 billion in settlements, including numerous violations for promotion of the diabetes drug Avandia.

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Thursday, September 27th, 2012

Not Your Typical Presidential Debate Forum For Obama, Romney

There’s nothing unusual about the way The New England Journal of Medicine displays the “Perspective” section this week: In dueling columns, under an original article on a “novel androgen-receptor blocker” for prostate cancer. But the authors of two of the perspectives are far from typical: B. Obama and M. Romney.

The introduction to both is basic:

The editors asked the Democratic and Republican presidential nominees, President Barack Obama and former Massachusetts Governor Mitt Romney, to describe their health care platforms and their visions for the future of American health care. Their statements follow.

And though the audience is far different from those at typical campaign stops, both candidates brought out familiar points.

Mitt Romney promises to repeal the health law and to replace it:

In the health care system that I envision, costs will be brought under control not because a board of bureaucrats decrees it but because everyone — providers, insurers, and patients — has incentives to do it. Families will have the option of keeping their employer-sponsored coverage, but they will also be empowered to enjoy the greater choice, portability, and security of purchasing their own insurance plans. As a result, they will be price-sensitive, quality-conscious, and able to seek out the features they want. Insurers will have to compete for their business. And providers will find themselves operating in a context where cost and price finally matter. Competition among providers and choice among consumers has always been the formula for better quality at lower cost, and it can succeed in health care as well.

Romney says he would make no changes to Medicare for today’s beneficiaries or those enrolled for the next 10 years and he advocates for Medicaid block grants to the states.

Obama promotes the features of the health law that have already proved popular, such as beginning to close the Medicare prescription drug doughnut hole and coverage for young adults on their parents’ insurance plans. And he promises:

If I am elected for a second term, I will follow through on all the work we have started together to implement the Affordable Care Act. I have also been clear that additional steps are needed. We need a permanent fix to Medicare’s flawed payment formula that threatens physicians’ reimbursement, rather than the temporary measures that Congress continues to send to my desk. I support medical malpractice reform to prevent needless lawsuits without placing arbitrary caps that do nothing to lower the cost of care.  I also know we must continue to support life-sciences research and ensure that our regulatory system helps bring new treatments and tools to pharmacies, doctors’ offices, and hospitals across the country

Obama and Romney both provided the standard NEJM disclosure form, a typical way scientific journals ensure that readers know about any funding source or conflicts of interest.

Thursday, September 27th, 2012

Today’s Headlines – Sept. 27, 2012

Today’s early morning highlights from the major news organizations, including reports about how the health law and Medicare are buzz words in public opinion polls and on the campaign trail.

Los Angeles Times: Romney Cites His Healthcare Law As Proof Of His Compassion
Mitt Romney, while campaigning in Ohio on Wednesday, highlighted the healthcare law that he passed while governor of Massachusetts as proof of his empathy for people. … The healthcare law is controversial among conservatives because it included a mandate that nearly every state resident purchase the insurance or be fined; it served as the model of the federal healthcare law that is Obama’s signature act as president, and that is an anathema to many Republicans (Mehta, 9/26).

Politico: Romney Hits ‘Obamacare’ In Ohio
Facing falling poll numbers in Ohio, Mitt Romney reconfigured his stump speech here, ratcheting up his attack on President Barack Obama’s health care law and returning to his once-abandoned talking points about the Founding Fathers and the debt clock. … Instead of simply vowing to repeal the health care overhaul, Romney spoke more about the danger it poses to American freedoms (Gibson, 9/26).

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Thursday, September 27th, 2012

Md. Blues Chief Blasts Plan To Shift Hospital Costs To Insurers

Negotiations to avert a breakdown in Maryland’s unique system of regulating hospital prices have deteriorated into a stalemate between the state’s largest insurer and the Maryland Hospital Association. CareFirst BlueCross BlueShield CEO Chet Burrell, speaking out for the first time about the talks, blames hospitals for their proposal to shift hundreds of millions in costs to CareFirst and other private insurers in an attempt to control rising Medicare spending.

“Not only were we high cost already,” said Burrell, referring to Maryland private-sector medical costs, “now you say, ‘Let’s shift costs to the private sector from the public sector and make it worse’? Is that what constitutes sound public policy? We have said cost shifting is not a path to go down.”

Maryland is the only state that sets hospital prices for all payers, including the federal Medicare program for seniors and the disabled. It’s allowed to do so only so long as Medicare costs per hospital admission rise no faster over time in Maryland than in the rest of the country. Because Maryland is close to breaking this speed limit for its Medicare “waiver,” medical providers and federal and state policymakers have been talking all summer about a redesign.

The idea is for the Department of Health and Human Services to use its regulatory authority to change the rules. HHS officials have urged Maryland to think big, using its system to install new cost controls not just for all payers but for all providers, including physicians and drug vendors.

But the federal agency especially wants to rein in hospital Medicare spending. To address its concerns the hospital association has proposed giving Medicare and Medicaid sharp discounts while raising hospital rates for commercial insurers by 7 percent over three years — beyond normal health care inflation.

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Thursday, September 27th, 2012

Today’s Headlines – Sept. 26, 2012

Today’s early morning highlights from the major news organiations, including reports about a round of new polls sizing up the status of the presidential campaign as well as one from The Associated Press measuring public opinion about the implementation of the health law.

The New York Times: Test For Obama As Deficit Stays Over $1 Trillion
Mr. Romney is proposing to reduce the deficit and encourage economic growth by substantially shrinking the government — unrealistically so, in the judgment of many budget experts — while further cutting taxes and increasing spending on the military. He would inject more private sector competition into Medicare to rein in the quickly growing costs of health insurance for older people and would limit Medicaid payments to fixed amounts to the states. Mr. Obama wants to combine spending cuts and tax increases on upper-income households to close the fiscal hole without fundamentally reducing the role of government or altering the government guarantees at the heart of Medicare, Medicaid and Social Security. Those programs account for 40 percent of federal spending, and they will grow to half in a decade as more baby boomers claim benefits (Calmes, 9/25).

The Associated Press/Washington Post: AP-GfK Poll: Most Say Obama’s Health Care Law Will Be Implemented; But 7 In 10 Expect Changes
They may not like it, but they don’t see it going away. About 7 in 10 Americans think President Barack Obama’s health care law will go fully into effect with some changes, ranging from minor to major alterations, an Associated Press-GfK poll finds. Just 12 percent say they expect the Affordable Care Act — “Obamacare” to dismissive opponents — to be repealed completely (9/26).

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Wednesday, September 26th, 2012

Today’s Headlines – Sept. 25, 2012

Today’s early morning highlights from the major news organizations, including reports about a new study that details accelerating health care spending.

Los Angeles Times: Presidential Debate Questions Sync Up With Voter Concerns
A new Pew Research Center polling analysis, released Monday, finds that the economy is voters’ dominant concern in this fall’s presidential election. An overwhelming proportion 87% said the economy would be “very important” to their vote (the same percentage as in the 2008 presidential contest). The jobs issue was a close second. … Other topics — healthcare and the size and scope of government — will occupy most of the remainder of the initial debate, along with questions about governing. … On healthcare, a matter of greater importance for women than for men, recent polling by the Pew Center found that Obama holds an advantage over Romney when voters were asked which candidate would do a better job of dealing with the issue. The same goes for Medicare, which ranked sixth in importance for swing voters (West, 9/24).

NPR: Romney Medicaid Remarks Raise Eyebrows
It’s not so much what Mitt Romney said about whether the government should guarantee people health care in his interview on CBS’s “60 Minutes” Sunday that has health care policy types buzzing. It’s how that compares to what he has said before (Rovner, 9/25).

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Tuesday, September 25th, 2012

Higher Prices By Hospitals, Other Providers, Drove 2011 Spending Increases, Study Finds

Source: Health Care Cost Institute

Spending on medical care for Americans with job-based insurance rose 4.6 percent last year, driven mainly by higher prices charged by hospitals and other medical providers, a report out today says.

The growth came despite a sluggish economy which some economists thought would translate into more modest spending growth. Still, last year’s per enrollee increase ranks below the 5.8 percent increase in 2009, according to the Health Care Cost Institute, a nonpartisan research group funded by insurers.

It isn’t clear from the data whether last year’s uptick represents a return toward  the higher averages of the past – or whether it was an anomaly within a general slowdown, said David Newman, executive director of the institute.  The institute noted the 2010 slowdown in its first report, which documented a 3.8 percent spending increase for privately insured Americans that year.

The current report found that employers in the Northeast spent the most on health care last year, at $4,659 per enrollee, while those in the West had the lowest tab at $4,358.

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Tuesday, September 25th, 2012

Study Links Longer Office Hours, Lower Health Care Costs

After primary care doctors close their doors on weekends and evenings, patients turn to urgent care facilities, pharmacy ‘minute clinics’, and emergency rooms to get the care they need. In doing so, they may also be contributing to the nation’s skyrocketing health system costs.

“When a patient shows up in the emergency room, the assumption is usually that they are more likely to be sick than not,” says Dr. Anthony Jerant, a professor of family and community medicine at the University of California-Davis School of Medicine.

Just being inside an emergency room is expensive. “[The doctor] might be thinking ‘wow, if they felt bad enough to come to an urgent care or emergency room they must be sick. So we should do a pretty through work-up and do every test known to man.’” And since emergency room providers are unfamiliar with a patient’s medical history, they will order multiple tests “because they don’t want to miss something,” Jerant says.

All of this adds up — but Jerant and his team of researchers at the UC Davis Center For Health Care Policy Research published a study in the September/October Annals of Family Medicine that offers a suggestions that can help patients avoid this scenario.

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Monday, September 24th, 2012

Today’s Headlines – Sept. 24, 2012

Today’s early morning highlights from the major news organizations, including reports about the latest health politics and policy news.

The New York Times: Obama And Romney Offer A Possible Preview Of Their First Debate
Mr. Romney said he would consider means-testing for Social Security benefits for future retirees, and he put some distance between his plans for reshaping Medicare as a voluntary voucher program and the proposal by his running mate, Representative Paul D. Ryan, to reduce payments to the health care program by some $700 billion. … Mr. Obama took a fairly combative tone in his interview, defending the administration’s actions on financial bailouts, health care legislation and efforts to help homeowners and job seekers (Broder, 9/23).

Politico: ‘Obamacare’ Foes Fear GOP Losses
If Mitt Romney doesn’t win the White House in November, and the Republicans don’t win the Senate, the GOP might not get another chance to repeal “Obamacare.” That’s the reality of the 2012 election, and even the staunchest opponents of the Democrats’ health care reform law acknowledge it. By the time the 2014 election comes up, all of the law’s major changes will be in place. So if the Republicans don’t win control of the White House and Congress to repeal it before then, the goal of wiping away the law will probably be out of their reach (Haberkorn, 9/22).

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Monday, September 24th, 2012

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