Viewpoints: Anthem’s ER Policy Is ‘Anti-Consumer’; China Is Preparing To Threaten U.S. Lead in Science
Opinion writers from around the country look at these topics and other health care issues.
Los Angeles Times:
Anthem Expands Its Policy Of Punishing Patients For 'Inappropriate' ER Visits
Over the last few months, Anthem, the nation's biggest health insurer, has informed customers in several states that if they show up at the emergency room with a problem that later is deemed to have not been an emergency, their ER claim won't be paid. The policy has generated protests from numerous physician groups, including ER doctors, as well as pointed questions on Capitol Hill and among state regulators. So Anthem has taken the obvious next step: This year, it's rolling out the policy in three additional states. Prior to Jan. 1, the policy was in effect in Georgia, Missouri and Kentucky. This year, it's adding New Hampshire, Indiana and Ohio. More states may follow. (Michael Hiltzik, 1/24)
The New York Times:
Falling Short On Science
Cambridge, Mass. — Amid the budget turbulence in Washington, it’s easy to miss the fact that part of what’s at stake is America’s dominance in science, engineering and innovation. The United States has been the world leader in these categories for so long that we have stopped believing it could be any other way. But other nations, seeing us lose focus, are seizing the chance to rise. (Maria T. Zuber, 1/26)
Forbes:
Should The Federal Government Negotiate Drug Prices?
Proponents neglect the possibility – which based on past experience, is a very likely outcome – that federal negotiations could increase drug prices rather than reduce them. They also neglect the possibility that by insisting on prices that are too low, the government might make certain drugs simply unavailable. (Robert Book, 1/24)
New England Journal of Medicine:
PEPFAR — 15 Years And Counting The Lives Saved
In the long history of successful public health initiatives, such as those leading to the eradication of smallpox, the elimination of polio throughout most of the world, and the marked reduction globally in vaccine-preventable childhood diseases, few programs have matched the impact of one that began in 2003, the President’s Emergency Plan for AIDS Relief, or PEPFAR. This innovative program has had an unprecedented impact on the pandemic of HIV and AIDS. (Anthony S. Fauci and Robert W. Eisinger, 1/25)
New England Journal of Medicine:
Treating And Preventing HIV With Generic Drugs — Barriers In The United States
Combination antiretroviral therapy (ART) has dramatically improved survival rates among people with HIV and is a mainstay of HIV prevention; evidence shows that durable viral suppression prevents the transmission of infection. In addition, preexposure prophylaxis (PrEP) is an emerging approach to preventing HIV acquisition for certain high-risk groups. Generic ART medications offer the potential for treating and preventing HIV with fewer resources. Generic versions of lamivudine, abacavir, and efavirenz became available in the United States within the past 6 years at prices lower than their brand-name counterparts, a generic version of PrEP (emtricitabine and tenofovir disoproxil fumarate) was approved in 2016, and generic versions of tenofovir disoproxil are expected later in 2018. Yet most of the discussion about the availability of generic HIV drugs focuses on low- and middle-income countries. (Erika G. Martin and Bruce R. Schackman, 1/25)
New England Journal of Medicine:
Discounted Drugs For Needy Patients And Hospitals — Understanding The 340B Debate
On November 1, 2017, the Centers for Medicare and Medicaid Services (CMS) finalized its rule for reducing Medicare Part B payments to hospital outpatient departments for prescription drugs in the 340B Drug Pricing Program. Instead of reimbursing hospitals at the average sales price (ASP) plus 6%, CMS will now reimburse at ASP minus 22.5%, reducing spending by an estimated $1.6 billion in 2018. Though these planned cuts have been lauded by patient advocacy groups and the pharmaceutical industry as a way of limiting abuses of the 340B program and lowering out-of-pocket costs, they have not been well received by hospitals. The controversy surrounding the 340B program is as complicated as the program itself, and the new payment policy is the latest chapter in a drama that has played out over years. (Walid F. Gellad and A. Everette James, 1/25 )
The New York Times:
The Men Who Want To Live Forever
Would you like to live forever? Some billionaires, already invincible in every other way, have decided that they also deserve not to die. Today several biotech companies, fueled by Silicon Valley fortunes, are devoted to “life extension” — or as some put it, to solving “the problem of death. ”It’s a cause championed by the tech billionaire Peter Thiel, the TED Talk darling Aubrey de Gray, Google’s billion-dollar Calico longevity lab and investment by Amazon’s Jeff Bezos. The National Academy of Medicine, an independent group, recently dedicated funding to “end aging forever.” (Dara Horn, 1/25)
The Washington Post:
Rest Easy About Trump’s Fitness
In recent weeks, a narrative has gained traction in Washington questioning whether Donald Trump is capable of being the president. ... So this week, I asked CIA Director Mike Pompeo, who personally briefs the president almost every day, to take us inside how Trump receives his most highly classified briefing: the president’s daily brief, or PDB. ... This is a very different picture of Trump’s national security leadership than many in Washington imagine. (Marc A. Thiessen, 1/25)
New England Journal of Medicine:
Beyond Burnout — Redesigning Care To Restore Meaning And Sanity For Physicians
Burnout rates are now twice as high in medicine as in other fields, even after adjustment for factors such as age, sex, level of education, and hours worked in the past week. In 2014, a national survey found that 54% of U.S. physicians reported at least one symptom of burnout: emotional exhaustion, depersonalization, or a diminished sense of personal accomplishment due to work-related stressors. Those in “front-line” specialties, including general internal medicine, family medicine, emergency medicine, and neurology, are at the highest risk. (Alexi A. Wright and Ingrid T. Katz, 1/25)
Stat:
An Ultrasound On Instagram Suggested The Baby Could Be In Danger. Does A Physician Have A Duty To Warn?
There’s no question that when a physician provides medical advice via social media it must be accurate. A nonmedical individual can comment based on blogs and personal experience, while physicians must give opinions based only on evidence. But whether they’re required to do that, or even if it’s a good idea, is an open question. In most social media situations, the two of us and our medical colleagues can be considered “physician civilians” — no doctor-patient relationship exists that creates an obligation for us to provide advice. (Casey Humbyrd and Kavita Shah Arora, 1/25)
USA Today:
Teen-Agers Need Good Policy And Good Parenting To Get More Sleep.
Despite considerable scientific evidence demonstrating that later school start times are associated with more sleep among adolescents, as well as improvements in well-being, public safety and academic performance, resistance to changing start times remains high. One of the most oft-repeated arguments against later start times goes something like this: “It’s not about school start times. It’s about bad parenting!”As a parent of a teenager myself, and as a sleep scientist, I absolutely agree that good parenting, is critical for healthy sleep. But when it comes to curbing the epidemic of teen sleep loss, good parenting can do only so much. (Wendy Troxel, 1/26)
San Francisco Chronicle:
We Can Prevent Disease By Using Food As Medicine
Practicing culinary medicine is a low-cost, accessible and culturally adaptable intervention. This entails educating patients about a healthy diet — one rich in vegetables and fruits and low in processed foods and animal products — and how to cook it. (Linda Shiue, 1/25)
Georgia Health News:
Expand Coverage, But Don’t Tie It To Employment
After years of Georgia rejecting expansion of Medicaid, there has been increasing political talk about the state pursuing a federal waiver to give health insurance to more people. At the same time, though, requiring that Medicaid beneficiaries work to retain their coverage has picked up momentum nationally, with the Trump administration allowing Kentucky to pursue that switch. (Laura Colbert, 1/25)
